Predictors and clinical characteristics of ruptured ectopic pregnancy: A retrospective analysis

Yeliz Çeçen Dönmez; Esra Keles; Fatih Şanlıkan; Sahra Sultan Kara; İsmail Bağlar; Cansu Ergenç; Sümeyye Nur Gökgöz; Şevki Göksun Gökulu

doi:10.19161/etd.1786283

TR EN

Rüptüre ektopik gebeliğin risk faktörleri ve klinik özellikleri: Retrospektif bir inceleme

Öz

Amaç: Bu çalışmanın amacı, ektopik gebeliği (EG) olan kadınlarda tubal rüptür ile ilişkili özgül risk faktörlerini ve klinik özellikleri belirlemek ve analiz etmektir. Gereç ve Yöntem: 2015–2024 yılları arasında üçüncü basamak bir sağlık merkezinde EG tanısı alan 180 kadın retrospektif olarak incelendi. Hastalar iki gruba ayrıldı: tubal rüptür gelişenler (n=132) ve rüptür gelişmeyen EG olguları (n=48). Hastaların demografik özellikleri, üreme öyküleri, başvuru sırasındaki klinik bulguları, serum beta-human chorionic gonadotropin (β-hCG) düzeyleri ve cerrahi sonuçları değerlendirildi. Bulgular: Rüptüre EG olguları anlamlı olarak daha genç (31,2 ± 5,5 vs. 33,3 ± 5,8 yıl; p=0,026) ve ortalama serum β-hCG düzeyleri daha düşüktü (3037,9 ± 4438,5 vs. 5483,6 ± 5300,8 mIU/mL; p=0,006). Önceki EG öyküsü ve tubal cerrahi öyküsü, rüptür gelişmeyen olgularda daha sık saptandı (sırasıyla p=0,018 ve p=0,017). Çok değişkenli lojistik regresyon analizinde; daha genç yaş (düzeltilmiş olasılık oranı [aOR] 0,91; %95 GA, 0,84–0,98; p=0,018), karın ağrısı varlığı (aOR 3,27; %95 GA, 1,06–10,05; p=0,039) ve düşük serum β-hCG düzeyleri (p<0,001) bağımsız rüptür öngördürücüleri olarak doğrulandı. Cerrahi tedavide salpenjektomi, rüptüre olgularda baskın prosedür olarak uygulandı (%97,7), bu oran rüptür gelişmeyenlerde daha düşüktü (%89,6; p=0,006). Sonuç: Ektopik gebelikte tubal rüptür, bağımsız olarak daha genç yaş, düşük serum β-hCG düzeyleri ve karın ağrısı varlığı ile ilişkili bulundu. Önceki ektopik gebelik öyküsü ise rüptür gelişmeyen olgularda daha sık gözlendi.

Anahtar Kelimeler

Predictors and clinical characteristics of ruptured ectopic pregnancy: A retrospective analysis

Abstract

Aim: This study aimed to identify and analyze the specific risk factors and clinical characteristics associated with tubal rupture in women with ectopic pregnancy (EP). Materials and Methods: A retrospective analysis was conducted on 180 women diagnosed with EP at a tertiary care center between 2015 and 2024. Patients were stratified into two groups: those with tubal rupture (n=132) and those with unruptured EP (n=48). Patient demographics, reproductive history, presenting clinical signs, serum beta-human chorionic gonadotropin (β-hCG) levels, and operative outcomes were collected. Results: Women with ruptured EP were significantly younger (31.2 ± 5.5 vs. 33.3 ± 5.8 years; p = 0.026) and presented with significantly lower mean serum β-hCG concentrations (3037.9 ± 4438.5 vs. 5483.6 ± 5300.8 mIU/mL; p = 0.006). A history of a prior EP and tubal surgery was more frequent among unruptured cases (p = 0.018 and p = 0.017, respectively). In multivariable logistic regression, younger age (adjusted odds ratio [aOR] 0.91; 95% CI, 0.84–0.98; p = 0.018), the presence of abdominal pain (aOR 3.27; 95% CI, 1.06–10.05; p = 0.039), and lower serum β-hCG (p <0.001) were confirmed as independent predictors of rupture. Salpingectomy was the predominant surgical procedure in ruptured cases (97.7%) compared to unruptured cases (89.6%; p = 0.006). Conclusion: Tubal rupture in EP was independently associated with younger age, lower serum β-hCG levels, and the presence of abdominal pain. A history of EP was observed more frequently among unruptured cases

Keywords

Supporting Institution

None.

Ethical Statement

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Research Ethics Committee of University of Health Sciences, Kartal Kosuyolu Training And Research Hospital Clinical Research Ethics Committee (number: 2024/14/891).

Thanks

None.

References

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National Guideline Alliance (UK). Diagnostic accuracy of ultrasound features for tubal ectopic pregnancy: Ectopic pregnancy and miscarriage: diagnosis and initial management: Evidence review A. London: National Institute for Health and Care Excellence (NICE); 2019 Apr. (NICE Guideline, No. 126.) Available from: https://www.ncbi.nlm.nih.gov/books/NBK576537/

Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Yeliz Çeçen Dönmez
0009-0003-1081-2993
Türkiye

Esra Keles ^*
0000-0001-8099-8883
Türkiye

Fatih Şanlıkan
0000-0002-3166-7129
Türkiye

Sahra Sultan Kara
0000-0001-5122-829X
Türkiye

İsmail Bağlar
0009-0008-0619-7111
Türkiye

Cansu Ergenç
0000-0002-4722-0911
Türkiye

Sümeyye Nur Gökgöz
0009-0009-0142-014X
Türkiye

Şevki Göksun Gökulu
0000-0002-6581-5716
Türkiye

Publication Date

March 9, 2026

Submission Date

September 18, 2025

Acceptance Date

October 28, 2025

Published in Issue

Year 2026 Volume: 65 Number: 1

DOI

https://doi.org/10.19161/etd.1786283

IZ

https://izlik.org/JA69MK93WZ

Cite

RIS / Bibtex

Vancouver

1.Yeliz Çeçen Dönmez, Esra Keles, Fatih Şanlıkan, Sahra Sultan Kara, İsmail Bağlar, Cansu Ergenç, Sümeyye Nur Gökgöz, Şevki Göksun Gökulu. Predictors and clinical characteristics of ruptured ectopic pregnancy: A retrospective analysis. EJM. 2026 Mar. 1;65(1):75-81. doi:10.19161/etd.1786283