Determinants and Diagnosis of Ectopic Pregnancy in PMC Hospital Nawabshah

Background: Ectopic pregnancy, characterized by the implantation of a fertilized ovum outside the uterine cavity, remains a critical obstetric emergency, significantly contributing to first-trimester maternal morbidity and mortality, necessitating prompt diagnosis and intervention to mitigate adverse outcomes. Objective: To find out determinants and diagnosis of ectopic pregnancy in PMC Hospital Nawabshah. Methodology: This Cross-sectional descriptive study was conducted at OBGYN I and II, MNCH, PUMHS, Nawabshah, Pakistan during the period from 10 October 2023 to 09 April, 2024. Ethical review committee permission was taken, and women fulfilling the inclusion criteria and consented to participate were included in the study.  A complete history is taken, the examination done, and a specialized investigation performed (beta HCG, and ultrasound) then the diagnosis of ectopic pregnancy is confirmed. Several parameters were evaluated (age, parity, residency, S/E/C, smoking, hx of ectopic pregnancy in the past, IUCD, EC Pills, pelvic surgery, subfertility, PID, housewife by occupation, education, clinical presentation, and complication). Data was collected and filled on the pre-formed questionnaire and analyzed in SPSS version 25. Result: A total of 51 patients were selected with ectopic pregnancy with a prevalence of 1.4%. The mean age of patients seen was 22.98 ± 4.889, 51% belonged to low SEC, while 41% to middle. 52% were nullipara, 25.5% fell into para 2-5, 62.7% were from rural areas, 11.8% were smokers, 15.7% had a history of ectopic, subfertility in 19.6%, PID in 37.3%, 5.9%, used IUCD, and 11.8% used EC Pills in the past. 19.6% had exposure to pelvic surgery in the past, 52.9% were housewives by occupation, with an education level below primary level 74.5% were (43% had no formal education and 31% up to primary), and 78.4% were Muslims. Clinical presentation mix 31.4%, pain 17.6%, amenorrhoea 11.8%, shock 11.8%, U/S heterogeneous tubal mass in 49%, tubal g.sac 15.7%, tubal ruptured ectopic 11.8%, 1 patient with cornual ectopic one wd scar ectopic & 2 wd ovarian ectopic, Complication 15.7% blood tx, 2% reaction, mx salpingectomy 76.5%, medical 11.8%, oophorectomy 3.9%. Conclusion: The study on ectopic pregnancy shows that it predominantly affects women aged 26-30 years and is associated with risk factors such as infections, previous surgeries, and infertility. Early detection and appropriate management, mainly surgical, are crucial for reducing complications and improving outcomes.