Joshi Neha
Obstetrics and Gynaecology, M. R. Bangur Hospital, Kolkata, IND.
Gynaecology and Reproductive Medicine, London Women's Clinic, Darlington, GBR.
Cureus. 2025 Feb 19;17(2):e79276. doi: 10.7759/cureus.79276. eCollection 2025 Feb.
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.
异位妊娠仍是产科实践中的一项重大挑战，在早期妊娠中对孕产妇发病率和死亡率有重大影响。早期诊断和干预对于优化结局及保留生育能力至关重要。这项基于医院的观察性研究旨在评估一家三级医疗中心异位妊娠的发病率、临床表现和结局，特别强调识别输卵管破裂的预测因素以促进早期干预策略。
这项前瞻性观察性研究于2018年6月至2019年5月在加尔各答M.R.班古尔医院妇产科进行了12个月。该研究纳入了年龄在18 - 44岁之间、根据临床检查、超声检查和手术结果诊断为异位妊娠的女性。样本量使用 Cochr an公式计算，预期患病率为2.3%，精度为0.03，得出最低需要106例病例。数据收集使用经过预试验的结构化表格进行。全面记录包括人口统计学参数、产科病史、危险因素、临床表现、诊断结果和治疗细节。
在5793例接受评估的妊娠患者中，确诊异位妊娠123例，发病率为2.1例。最高发病频率出现在26 - 30岁年龄组，有46例（37.4%），其次是31 - 35岁年龄组，有31例（25.2%）。既往流产是影响24例患者（19.5%）的主要危险因素，其次是盆腔炎，有22例（17.9%）。典型的三联征症状包括腹痛102例（82.9%）、闭经78例（63.4%）和异常阴道出血57例（46.3%）。壶腹部着床占大多数，有101例（82.1%）。术中发现104例（84.6%）有破裂，而最初的超声检查发现58例（47.2%）有破裂。100例（81.3%）进行了单侧输卵管切除术。对破裂状态的分析显示与既往危险因素或人口统计学参数无显著关联。
该研究突出了就诊时破裂异位妊娠的高患病率，强调了早期检测策略的必要性。超声检查和术中破裂发现之间的显著差异强调了即使影像学检查结果正常也需保持高度临床怀疑的重要性。
