Spectrum of Ectopic Pregnancy: Case Series from a Tertiary Care Centre in Western India

Ectopic pregnancy is a potentially life-threatening gynecological emergency and an important cause of first-trimester maternal morbidity. It may present with a wide spectrum of clinical manifestations, ranging from asymptomatic early diagnosis to catastrophic rupture with hemodynamic instability. Prompt diagnosis and timely intervention are crucial for successful outcomes. We present a case series of six patients managed for ectopic pregnancy at a tertiary care centre with varied presentations and management approaches. The series included three cases of ruptured tubal ectopic pregnancy, one unruptured tubal ectopic pregnancy, one unruptured rudimentary horn ectopic pregnancy, and one case of impending tubal abortion. One patient with a ruptured tubal ectopic pregnancy presented in a hemodynamically unstable condition and underwent emergency laparotomy. The remaining five patients were managed laparoscopically. Diagnosis in all cases was established by clinical assessment, serum beta-human chorionic gonadotropin levels, and ultrasonography findings. Surgical management was individualized according to the patient's clinical status, site of ectopic pregnancy, and intraoperative findings. Five patients had an uncomplicated postoperative recovery. One patient with a ruptured tubal ectopic pregnancy managed laparoscopically developed postoperative acute kidney injury, requiring further intensive management. Subsequent recovery was achieved with appropriate multidisciplinary care. All patients ultimately recovered satisfactorily. This case series highlights the varied clinical spectrum of ectopic pregnancy and emphasizes the importance of early diagnosis, individualized surgical management, and vigilant postoperative monitoring for optimal outcomes.