Incidence of Ectopic Pregnancies at a Tertiary Care Center of Tribal India: A Hospital-Based Cross-Sectional Study.

Background and aim Ectopic pregnancy remains a significant cause of maternal morbidity and mortality, particularly in low-resource settings where delayed diagnosis and limited healthcare access exacerbate adverse outcomes. The burden is even more pronounced among tribal populations due to systemic healthcare barriers. This study aimed to evaluate the clinical profile, risk factors, treatment modalities, and maternal outcomes of ectopic pregnancies managed at a tertiary care hospital catering to a predominantly tribal population in central India. Methods A hospital-based cross-sectional study was conducted at Birsa Munda Government Medical College (BMGMC), Shahdol, a tertiary healthcare facility in Madhya Pradesh, India, from February 2024 to January 2025. Pregnant women diagnosed with ectopic pregnancy based on clinical symptoms, transvaginal ultrasonography (TVS), and serum beta-human chorionic gonadotropin (β-hCG) assays were included. Comprehensive data on demographics, obstetric history, clinical presentation, laboratory findings, treatment modalities, and surgical outcomes were collected. Statistical analysis was performed using SPSS version 20.0 (Armonk, NY: IBM Corp.), with a p<0.05 considered statistically significant. Results A total of 92 ectopic pregnancy cases were analyzed. Abdominal pain (97.8%) and amenorrhea (95.7%) were the most common symptoms, with 66.4% presenting after 24 hours. The vast majority of cases were tubal (97.8%), with the ampullary segment being the most commonly affected site (71.7%). Ruptured ectopic pregnancy occurred in 84.8% of cases. Delayed presentation (OR: 9.82, 95% CI: 2.32-41.54; p=0.002), hemoglobin <10 g/dL (OR: 10.54, 95% CI: 2.94-37.82; p<0.001), and β-hCG >5000 mIU/mL (OR: 10.01, 95% CI: 2.06-48.69; p=0.004) were significantly associated with rupture. All cases required surgical intervention, with unilateral salpingectomy being the most common procedure (43.5%). The mean hospital stay was 4.8±2.1 days, and 28.3% required ICU care. No maternal mortality was reported. Conclusion This study underscores the high burden of ruptured ectopic pregnancies in tribal regions, driven by delays in presentation and limited healthcare access. Early diagnosis, improved primary care referral systems, and targeted community awareness programs are urgently needed to reduce preventable maternal morbidity in underserved populations.