Prevalence and Clinical Characteristics of Ectopic Pregnancy at a Tertiary Referral Hospital in Zambia: A Prospective Descriptive Study

Background: Ectopic pregnancy (EP) remains a major cause of early pregnancy-related morbidity and mortality, particularly in low-resource settings where late presentation and limited diagnostic capacity prevail. Despite being a preventable cause of maternal death, local data on its burden and clinical characteristics in Zambia remain limited. Objective: To determine the prevalence, socio-demographic patterns, clinical characteristics, and outcomes of ectopic pregnancy at Ndola Teaching Hospital (NTH), Zambia. Methods: A prospective, descriptive, hospital-based study was conducted among 94 women with surgically confirmed ectopic pregnancies between June 2024 and April 2025. Participants were recruited through purposive sampling. Data were collected using structured questionnaires and review of medical records, then analyzed using IBM SPSS version 27. Descriptive statistics were computed, and associations between categorical variables were tested using the Chi-square test at a significance level of p < 0.05. Results: Out of 9402 pregnant women managed during the study period, 94 were diagnosed with ectopic pregnancy, yielding a prevalence of 0.99%. The mean age was 28.3 ± 5.8 years, with most participants residing in low-income areas (79.8%) and being married (84%). A prior history of pelvic inflammatory disease (PID) was reported in 57.4%, while 35.1% had used emergency contraception. The most frequent presenting symptoms were lower abdominal pain (96.8%), amenorrhea (74.5%), and vaginal bleeding (62.8%). At surgery, 88.3% of cases were ruptured, and 41.5% presented in haemorrhagic shock. Abdominal pain showed a statistically significant association with ruptured ectopic pregnancy (p < 0.001), while a history of pelvic inflammatory disease was significantly associated with the presence of pelvic adhesions (p = 0.015). The case fatality rate was 1.1%. Conclusion: Ectopic pregnancy at NTH remains a significant reproductive health challenge, characterized by late presentation, high rupture rates, and severe complications. The findings highlight the need for strengthened early diagnostic capacity, improved access to emergency care, and enhanced reproductive health education, particularly targeting women in low-income communities.