Determinants of Surgical and Medical Management in Ectopic Pregnancy: A Retrospective Analysis from a Tertiary Care Center

Abstract

Background: Ectopic pregnancy is a life-threatening condition and a substantial contributor to maternal morbidity. Advancement in ultrasonographic and biochemical evaluation allows for earlier identification and a broader range of methods of managing the disease. Aim and Objective: To evaluate demographic, clinical, and biochemical predictors of the choice of management modality in ectopic pregnancy. Question for the study was as follows: Which patient characteristics are predictors of surgical in comparison to medical management of ectopic pregnancy? Methods: A hospital-based retrospective study of 101 patients who presented with ectopic pregnancy was performed. Demographic variables, parity, BMI, presenting symptoms, ultrasonographic characteristics, and the concentration of serum β-hCG were examined. Treatment with laparotomy, laparoscopy, or methotrexate was performed. Statistical analyses included descriptive statistic, chi-square, Fisher's exact, ANOVA, Kruskal–Wallis, Spearman correlation, and logistic regression. Results: Older age, high β-hCG, and multigravidad were independently associated with surgical intervention, namely laparotomy and salpingectomy. Primigravidae and early pregnancies were significantly more likely to receive salpingostomy or medical therapy. BMI had no independent effect on management. Logistic regression identified parity (3.2, 1.6–6.5) and β-hCG >2000 IU/L (4.8, 2.0–11.2) as independent predictors of surgical intervention. Conclusion: Treatment of ectopic pregnancy is influenced by parity, β-hCG, and age, and parity and β-hCG are independent predictors. Patient-specific care remains a primary focus, and future application of predictive analytics and minimally invasive approaches may further maximize success.