Early Diagnosis and Treatment Outcomes of Unruptured Ectopic Pregnancy in a Tertiary Care Hospital

Open Access

Abstract

Background: Ectopic pregnancy remains a significant cause of maternal morbidity, particularly when diagnosis is delayed and tubal rupture occurs. Early identification of unruptured ectopic pregnancy provides an opportunity for conservative treatment and improved maternal outcomes. Advances in transvaginal ultrasonography and serum β-hCG monitoring have enhanced early diagnosis and treatment selection. Aim of the study: This study aimed to evaluate the clinical characteristics, diagnostic approaches, treatment modalities, and early treatment outcomes of unruptured ectopic pregnancy in a tertiary care hospital. Methods & Materials: This prospective observational study was conducted in the Department of Obstetrics and Gynecology at a tertiary care hospital in Bangladesh over one year. A total of 150 women with confirmed unruptured ectopic pregnancy were included. Patients were categorized into medical management (n=58) and surgical management (n=92) groups. Demographic characteristics, clinical presentations, diagnostic findings, treatment approaches, complications, treatment success, and follow-up outcomes were assessed. Statistical analysis was performed using SPSS version 26.0, and p<0.05 was considered statistically significant. Result: The mean age of participants was 28.6±5.2 years, and lower abdominal pain (85.33%) was the most common presenting symptom. Ampullary tubal pregnancy was the predominant ectopic site (72.00%). Medical management was performed in 38.67% of patients, while 61.33% underwent surgical treatment. Overall treatment success was achieved in 88.00% of cases. Treatment success was comparable between medical and surgical groups (86.21% vs 89.13%, p=0.61). Surgical management was associated with shorter β-hCG resolution time (14.8±5.6 vs 24.6±8.2 days, p<0.001), whereas medical management resulted in shorter hospital stay (2.8±1.1 vs 4.2±1.5 days, p<0.001). Early presentation, β-hCG ≤5000 IU/L, adnexal mass ≤3 cm, absence of fetal cardiac activity, and early TVS diagnosis were significant predictors of successful outcomes. Conclusion: Early detection of unruptured ectopic pregnancy enables individualized treatment selection and favorable clinical outcomes. Both medical and surgical management approaches were effective when appropriately selected. Timely diagnosis through clinical assessment, β-hCG monitoring, and ultrasonography remains essential for reducing complications and improving reproductive outcomes.