Incidence, Risk Factors and Clinical Profile of Ectopic Pregnancy in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Ectopic pregnancy is a potentially life-threatening gynecological emergency. In developing countries like Bangladesh, it often presents late with tubal rupture and hemodynamic instability. It is a major cause of maternal morbidity and mortality among women of reproductive age. Globally, the incidence of ectopic pregnancy has increased over the past decades, rising from approximately 0.5% in 1970 to nearly 4% in recent years. The purpose of this study was to determine the incidence, risk factors, and clinical profile of ectopic pregnancy. Materials and Methods: This was a cross-sectional observational study conducted in the Department of Obstetrics and Gynecology at Cumilla Medical College Hospital (CuMCH), Cumilla, from October 2021 to March 2022. A total of 105 patients with ectopic pregnancies were selected by purposive sampling. Ectopic pregnancy was diagnosed by a positive urinary pregnancy test or serum β-hCG, along with ultrasonography. Patients who were clinically suspicious, but laparotomy findings ruled out ectopic pregnancy and who did not give consent were excluded. The collected data were analyzed using SPSS version 23.0, and descriptive statistics were employed to summarize the findings. Results: The overall incidence of ectopic pregnancy in this study was 2.1%. The most affected age group was 21-25 years (43.8%), with a mean age of 26.8 ± 5.6 years. Most patients were multiparous (61.0%), followed by primiparous (26.7%) and nulliparous women (12.4%). Amenorrhea (98.1%), abdominal pain (89.5%), and per-vaginal bleeding (67.6%) were the commonest presentations, with 12.4% presented shock. Previous abortion was the most frequent risk factor (44.8%), followed by pelvic inflammatory disease (26.7%), prior abdominopelvic surgery (25.7%), infertility (20.0%), and previous ectopic pregnancy (18.1%). The ampullary region was the most common site (60.0%), with a higher predominance on the right side (60%). Conclusion: Ectopic pregnancy remains a major gynecological emergency and a significant challenge to women’s reproductive health. A high index of suspicion is essential for early diagnosis before rupture, allowing the possibility of conservative management. Prompt diagnosis and timely intervention can reduce morbidity and mortality and improve future reproductive outcomes.

Eastern Med Coll J. 2026; 11 (1): 36-41