Pattern of Presentation and Management of Ectopic Pregnancy in Tertiary Care Hospital

Background: Ectopic pregnancy remains a significant obstetric emergency contributing to maternal morbidity and mortality, particularly in resource-limited settings where delayed diagnosis and complications frequently occur. Objective: To analyze clinical presentation patterns, risk factors, diagnostic parameters, and management outcomes of ectopic pregnancy among patients admitted to a tertiary care hospital. Methods: A hospital-based observational study is conducted in the Department of Gynecology and Obstetrics, Rajshahi Medical College Hospital, from January–December 2025. Ninety-eight confirmed ectopic pregnancy cases are included using purposive sampling. Data include demographic variables, reproductive history, risk factors, clinical presentation, β-hCG levels, ultrasound findings, management approach, complications, and hospital stay. Statistical analysis uses descriptive statistics, mean ± standard deviation, chi-square testing, and significance at p<0.05. Results: Among 98 patients, mean age is 27.9 ± 5.4 years. The largest group (46.9%) falls within 26–30 years. Abdominal pain occurs in 91.8%, amenorrhea in 86.7%, and vaginal bleeding in 62.2%. Previous pelvic inflammatory disease is identified in 29.6%, prior abortion in 24.5%, infertility treatment in 10.2%, and previous ectopic pregnancy in 7.1%. Mean serum β-hCG level at admission is 3215 ± 1480 mIU/mL. Ultrasound detects adnexal mass in 88.8% and hemoperitoneum in 41.8%. Ruptured ectopic pregnancy accounts for 57.1%. Surgical management is performed in 72.4%, while 19.4% receive methotrexate therapy and 8.2% are managed expectantly. Mean hospital stay is 4.6 ± 1.8 days. Significant associations are observed between delayed presentation and rupture (χ²=9.62, p=0.002) and between high β-hCG levels (>3000 mIU/mL) and surgical management (p=0.01). Conclusion: Ectopic pregnancy frequently presents with abdominal pain and amenorrhea. Early diagnosis using ultrasound and β-hCG assessment significantly improves management outcomes and reduces complications in tertiary healthcare settings. Article Details Section This work is licensed under a Creative Commons Attribution 4.0 International License. This journal provides immediate open access to its content under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Authors retain copyright and grant the journal the right of first publication. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. License details: https://creativecommons.org/licenses/by/4.0/ How to Cite

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