A Prospective Observational Study on Ectopic Pregnancy at Government General Hospital Guntur

Abstract

Objective: To determine the incidence, clinical presentation, diagnostic accuracy of various modalities, and management outcomes of ectopic pregnancy in a tertiary care center. Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Government General Hospital, Guntur, over 18 mo. A total of 182 women diagnosed with ectopic pregnancy were included. Clinical presentation, risk factors, diagnostic modalities, management strategies, and outcomes were analyzed. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for diagnostic tests. Results: Among 12,114 pregnancies, 182 were ectopic pregnancies, yielding an incidence of 1.5%. The mean age was 27.5±5.3 years. The most common symptoms were abdominal pain (90.76%), amenorrhea (79.23%), and vaginal bleeding (63.07%). Pelvic inflammatory disease (18%) and sterilization (18%) were the most common risk factors. The ampullary region was the most common site (84%). Serum β-hCG demonstrated sensitivity and specificity of 99.43% and 95.96%, respectively, while ultrasonography showed sensitivity and specificity of 98.71% and 97.50%. Surgical management was required in 89.01% of cases, whereas medical and expectant management were used in 7.14% and 3.85% of cases, respectively. Conclusion: Ectopic pregnancy continues to pose significant diagnostic and therapeutic challenges. Early diagnosis using β-hCG and transvaginal ultrasonography improves outcomes and allows conservative treatment in selected patients. Prompt intervention remains critical for reducing maternal morbidity.