FREQUENCY OF COMMON SIGNS AND SYMPTOMS OF ECTOPIC PREGNANCY

Abstract

Background: Ectopic pregnancy, defined as the implantation of a fertilized ovum outside the uterine cavity, is a potentially life-threatening condition and a leading cause of first-trimester maternal mortality. The clinical spectrum is wide, ranging from asymptomatic cases to severe hemodynamic compromise, and remains underexplored in local settings. This study was designed to systematically assess the frequency of common signs and symptoms of ectopic pregnancy in a selected population, aiming to enhance early detection and improve outcomes.

Objective: To evaluate the frequency of common clinical signs and symptoms of ectopic pregnancy and their demographic correlations in a population presenting to a tertiary care hospital.

Methods: This descriptive cross-sectional study was conducted at the Department of Obstetrics and Gynecology, Prime Teaching Hospital, Peshawar, from 1st April 2022 to 30th September 2022. Women aged 15–45 years diagnosed with ectopic pregnancy were included, while cases of miscarriage, molar pregnancy, and other pelvic pathologies were excluded. Ectopic pregnancy was confirmed via serum beta-human chorionic gonadotropin (>10 IU/mL) and transvaginal ultrasound. Data on demographics, clinical symptoms (amenorrhea, abdominal pain, vaginal bleeding), and clinical signs (abdominal tenderness, cervical excitation pain, mass in the Pouch of Douglas) were collected and analyzed using SPSS version 23. Frequencies and percentages were reported for qualitative variables, and means ± standard deviations for quantitative variables.

Results: The study included 80 participants with a mean age of 30.01 ± 5.518 years. Most patients (52.5%) were aged ≤30 years, with 57.5% residing in rural areas. The mean BMI was 23.988 ± 2.602 kg/m², and the mean parity was 3.15 ± 1.662. The most frequently reported symptom was amenorrhea (87.5%), followed by abdominal pain (81.3%) and vaginal bleeding (68.8%). Among clinical signs, abdominal tenderness was observed in 77.5%, cervical excitation pain in 62.5%, and a mass in the Pouch of Douglas in 31.3%.

Conclusion: This study demonstrated that ectopic pregnancy most commonly presents with amenorrhea and abdominal pain, while abdominal tenderness and cervical excitation pain are the most prevalent clinical signs. Early recognition of these features is essential for timely diagnosis and management, particularly in resource-limited settings.