Pioneering early diagnosis and management in ectopic pregnancy: A cross-sectional study to enhance maternal safety and clinical outcomes in a tertiary care setting.

Dr. Gangadhar  Rama; Tekupudi  Manasa; Dr. Varada A.  Hasamnis; Sravya  Pudi

doi:10.51168/sjhrafrica.v6i9.2011

Authors

Dr. Gangadhar Rama Postgraduate, Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Foundation , Amalapuram, Andhra Pradesh, India
Dr.Tekupudi Manasa Assistant Professor, Department of Obstetrics and Gynecology, Great Eastern Medical School, Srikakulam, Andhra Pradesh, India
Dr. Varada A. Hasamnis Assistant Professor, Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Foundation , Amalapuram, Andhra Pradesh, India
Dr. Sravya Pudi Postgraduate, Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Foundation , Amalapuram, Andhra Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i9.2011

Keywords:

Ectopic pregnancy, Risk factors, Clinical presentation, Diagnosis, Surgical management, Maternal morbidity, Early detection

Abstract

Background:
Ectopic pregnancy is a leading cause of maternal morbidity and mortality in the first trimester, requiring early diagnosis and prompt management to protect maternal health. This study evaluated the clinical spectrum, risk factors, implantation site, and management strategies in ectopic pregnancies.

Methods:

A cross-sectional observational study was conducted at Konaseema Institute of Medical Sciences & Research Foundation, Amalapuram, from November 2023 to November 2024. A total of 38 women diagnosed with ectopic pregnancy were enrolled. Data on demographics, clinical presentations, risk factors, ectopic site, and management modalities were collected. Descriptive statistics were analyzed using SPSS software.

Results:

The incidence of ectopic pregnancy was found to be 2%. The majority of women were below 26 years of age (65.7%) and multiparous (55.2%). Pelvic infections (31.5%) emerged as the predominant risk factor, followed by previous miscarriage (18.42%) and pelvic surgeries (15.7%). The most common clinical presentation was a combination of bleeding per vaginum and lower abdominal pain (50%). The ampulla of the fallopian tube was the site of implantation in 73.68% of cases. Surgical management was the mainstay in 84.2% of cases, predominantly through salpingectomy. Methotrexate was utilized in 2.6% of cases. Intraoperative findings revealed ruptured ectopic pregnancies in 76.3% of cases, necessitating blood transfusion in 31.5% of women.

Conclusion:

Ectopic pregnancy continues to pose significant clinical challenges, particularly when diagnosed late in the course of the disease. Early identification of high-risk women through vigilant assessment of risk factors, combined with rapid diagnostic protocols like transvaginal ultrasound and serum β-hCG levels, can markedly improve maternal outcomes. Surgical intervention remains the cornerstone of treatment in hemodynamically unstable cases, while select stable patients may benefit from medical therapy.

Recommendations:

Public health initiatives should prioritize infection prevention, enhance access to early antenatal care, and strengthen primary healthcare providers’ skills in detecting early ectopic pregnancy.

Author Biographies

Dr. Gangadhar Rama, Postgraduate, Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Foundation , Amalapuram, Andhra Pradesh, India

completed her Bachelor of Medicine and Bachelor of Surgery (MBBS) from Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Andhra Pradesh, India. Following her graduation, she worked as an Epidemiologist for the Non-Communicable Diseases (NCD) Program at the Office of the District Medical and Health Officer (DM&HO), Visakhapatnam, Andhra Pradesh, where she was actively involved in public health initiatives targeting chronic disease management and prevention.

She later served as a Civil Assistant Surgeon at the Primary Health Centre (PHC) in Pedabayalu, a remote tribal area under the Integrated Tribal Development Agency (ITDA), Paderu, Andhra Pradesh. During her three-year tenure, she gained extensive experience in delivering primary healthcare services to underserved populations, with a focus on maternal and child health.

Currently, Dr. Rama is pursuing her postgraduate specialization (MD/MS) in Obstetrics and Gynecology at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India. Her professional interests include women's reproductive health, high-risk obstetrics, and community-based maternal health interventions.ORCID iD: https://orcid.org/ 0009-0003-5099-6395

Dr.Tekupudi Manasa, Assistant Professor, Department of Obstetrics and Gynecology, Great Eastern Medical School, Srikakulam, Andhra Pradesh, India

is currently serving as an Assistant Professor in the Department of Obstetrics and Gynaecology at Great Eastern Medical School, Srikakulam, Andhra Pradesh, India. She earned her MBBS and M.S. in Obstetrics and Gynaecology from the prestigious Andhra Medical College, Visakhapatnam. Following her postgraduate training, she completed her Senior Residency at Konaseema Institute of Medical Sciences, Amalapuram, where she gained extensive clinical and teaching experience.

Her academic interests include high-risk obstetrics, infertility management, and evidence-based approaches to women’s health. She is actively involved in undergraduate medical education and contributes to clinical training and academic mentoring.ORCID iD: https://orcid.org/0009-0002-9468-9461

Dr. Varada A. Hasamnis , Assistant Professor, Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Foundation , Amalapuram, Andhra Pradesh, India

is currently serving as an Assistant Professor in the Department of Obstetrics and Gynaecology at the Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India. She obtained her MBBS degree from Dr. D.Y. Patil Medical College, Navi Mumbai, Maharashtra, followed by a Diploma in Obstetrics and Gynaecology from Lokmanya Tilak Municipal Medical College, Mumbai. She further enhanced her academic and clinical expertise by completing a Fellowship in Midwifery and a Diploma in Family Planning from the College of Physicians and Surgeons, Mumbai. With over two decades of extensive clinical experience in women's health, Dr. Hasamnis has developed a strong academic and research portfolio. She has authored 25 scientific publications in reputed medical journals, reflecting her commitment to evidence-based practice and continuous professional development. ORCID iD: https://orcid.org 0009-0002-8860-7183

Dr. Sravya Pudi, Postgraduate, Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Foundation , Amalapuram, Andhra Pradesh, India

is a postgraduate trainee in Obstetrics and Gynaecology at Konaseema Institute of Medical Sciences and Research Foundation, Amalapuram, Andhra Pradesh, India. She holds an MBBS degree from Andhra Medical College, Visakhapatnam. ORCID iD: https://orcid.org 0009-0001-1662-0111

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