A Retrospective Study on Reproductive Outcomes After Medical And Surgical Management of Tubal Ectopic Pregnancy

Abstract

Objectives: Ectopic pregnancy (EP) is a gynecological emergency as it is one of the major causes of maternal death in the first trimester. Currently, there is a lack of sufficient data on the success and future fertility rates in EP cases. To address this gap, we conducted a retrospective study to compare the success rates and the impact on fertility and reproductive outcomes of surgical versus medical management for tubal EP. Methods: It was a retrospective study conducted in the Department of Obstetrics and Gynaecology of a tertiary care hospital. Medical records of patients with ectopic pregnancy within the study period who satisfied the inclusion and exclusion criteria of the study were enrolled. The records of all patients enrolled in the study were analyzed and recorded in a specially designed data collection form. Results: There were 90 samples during the study period based on inclusion and exclusion criteria. Twenty-eight cases were managed medically, and another sixty-two cases were managed surgically. Subsequent positive pregnancy rates were 71.4% (20/28) after medical treatment and 51.6% (32/62) after surgical Intervention. Among patients who conceived following medical management, seven patients (35%) experienced recurrent ectopic pregnancy, and one patient had a first-trimester miscarriage. For patients who were managed surgically, fifteen patients (24.19%) had repeat ectopic pregnancy. Conclusion: Medical management of tubal ectopic pregnancy was associated with a higher subsequent pregnancy rate compared to surgical management, although this difference was not statistically significant. However, the risk of recurrent ectopic pregnancy was higher in the medically managed group. These findings highlight the need to balance fertility preservation with the risk of recurrence when selecting the appropriate management strategy.