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.