Clinical Profile, Risk Factors, and Outcomes of Ectopic Pregnancy: A One-Year Observational Study From a Tertiary Care Hospital in Eastern India.

Background Ectopic pregnancy remains a significant challenge in obstetric practice, contributing substantially to maternal morbidity and mortality in early pregnancy. Early diagnosis and intervention are crucial for optimizing outcomes and preserving fertility. This hospital-based observational study aimed to evaluate the incidence, clinical presentation, and outcomes of ectopic pregnancy at a tertiary care center, with particular emphasis on identifying predictors of tubal rupture to facilitate early intervention strategies. Methodology This prospective observational study was conducted at the Department of Obstetrics and Gynaecology, M. R. Bangur Hospital, Kolkata, over 12 months from June 2018 to May 2019. The study included women aged 18-44 years who were diagnosed with ectopic pregnancy based on clinical examination, ultrasonography, and surgical findings. Sample size was calculated using Cochran's formula, with an expected prevalence of 2.3% and precision of 0.03, yielding a minimum requirement of 106 cases. Data collection was performed using a structured pro forma that underwent pilot testing. Comprehensive documentation included demographic parameters, obstetric history, risk factors, clinical presentation, diagnostic findings, and treatment details. Results Among 5,793 pregnant patients evaluated, 123 cases of ectopic pregnancy were identified, yielding an incidence of 2.1 cases. The highest frequency was observed in the 26-30 year age group with 46 cases (37.4%), followed by 31-35 year group with 31 cases (25.2%). Previous pregnancy loss emerged as the predominant risk factor affecting 24 patients (19.5%), followed by pelvic inflammatory disease in 22 cases (17.9%). The classical triad of presenting symptoms included abdominal pain in 102 cases (82.9%), amenorrhea in 78 cases (63.4%), and abnormal vaginal bleeding in 57 cases (46.3%). Ampullary implantation represented the majority with 101 cases (82.1%). Intraoperative findings revealed rupture in 104 cases (84.6%), while initial ultrasonographic evaluation identified rupture in 58 cases (47.2%). Unilateral salpingectomy was performed in 100 cases (81.3%). Analysis of the rupture status showed no significant association with historical risk factors or demographic parameters. Conclusion The study highlights the high prevalence of ruptured ectopic pregnancies at presentation, emphasizing the need for early detection strategies. The significant disparity between ultrasonographic and intraoperative rupture findings underscores the importance of maintaining high clinical suspicion, even with normal imaging findings.