INCIDENCE OF RUPTURE OF ECTOPICPREGNANCYINEARLY GESTATIONAL AGE

Abstract

Background:Ectopicpregnancyisalife-threateningconditionwithaglobalprevalenceof1-2%.Early rupture, a significant complication, increases maternal morbidity and mortality due to hypovolemic shock and internal hemorrhage. Timely diagnosis remains challenging, particularly in early gestational weeks, where symptoms may be subtle. This study aimed to evaluate the incidence of rupture in ectopic pregnancies diagnosed during early gestational ages and identify associated demographic, clinical, and diagnostic factors.

Methods: This was a prospective observational study conducted at saveetha medical college and hospital over 12 months. A total of 64 participants diagnosed with ectopic pregnancy during the first trimester were enrolled based on clinical, laboratory, and imaging findings. Data on demographic characteristics, clinical symptoms, diagnostic parameters, and management strategies were collected. Descriptive statistics summarised participant characteristics, and multivariate logistic regression identified independent predictors of rupture.

Results: The incidence of rupture was 87% (n=56), predominantly managed via laparotomy (91%). Lower abdominal pain (84.4%), vaginal bleeding (75%), and abdominal tenderness (100%) were common clinical features. Key factors associated with rupture included lower parity (p=0.021) and hemoglobinlevels(p=0.025),Thedurationofamenorrheawasfoundtohaveasignificantassociation with rupture, with a coefficient of -2.150 (p = 0.009). This indicates that a shorter duration of amenorrhea(<6weeks)wassignificantlylinkedtoanincreasedlikelihoodofrupture.Beta-hCGlevels werenotpredictiveofrupturerisk(p=0.536).Participantswithrupturedectopicpregnanciesshowed higher rates of anemia (mean hemoglobin: 8.70 ± 1.94 g/dL) and hemodynamic instability (mean SBP: 93.75 ± 6.04 mmHg).

Conclusion:A shorter duration of amenorrhea (<6 weeks) was significantly associated with an increased risk of rupture (coefficient = -2.150, p = 0.009). The high incidence of rupture emphasizes the need for early diagnosis and intervention. Clinical indicators such as abdominal tenderness and anemia should prompt suspicion. Improving access to diagnostic tools and exploring non-surgical management options could mitigate complications and improve outcomes. Further research is needed to validate these findings and refine management protocols.