A comparison between ruptured and unruptured ectopic pregnancy and its association with the risk factors: A single center study

Abstract

Background: Rupture of ectopic pregnancy (EP) occurs mainly in the first trimester and is a life-threatening condition. It is a leading cause of maternal morbidity and mortality. Many risk factors had shown significant association with EP. This study aims to find the risk factors associated with ruptured and unruptured EP. Methodology: This prospective study was conducted among 60 ectopic pregnancy cases during a study period of one and half years. The study population was classified according to the rupture status. The variables assessed were baseline, investigative and operative findings, and risk factors of ectopic pregnancy. Analysis was done to find the association of these factors with rupture status. Results: Out of the 60 cases, the rupture was present in 35 patients and was absent in 25. Age, parity, and gestational age were not associated with rupture status. Investigative and operative findings are significantly associated with rupture status (Free fluid: p=0.001, Uterine size: p=0.029, Size of sac: p= 0.013, β-hCG: p=0.023, Site of ectopic pregnancy: p=0.001), i.e., abnormalities in these factors shows more chance of rupture in ectopic pregnancy cases. Risk factors such as the history of contraceptive use and sterilization show significance to rupture status (p=0.009 & p=0.006), respectively. Conclusion: Any women in the reproductive age group who presents with amenorrhea, lower abdominal pain, or bleeding per vaginum should be evaluated for EP, irrespective of the sterilization status and the history of contraceptive use to prevent the rupture and morbidity/mortality associated with the same.