Do Left and Right Tell Different Stories? A Clinico-diagnostic Analysis of Laterality in Ectopic Pregnancy Outcomes.

Objectives: Prompt diagnosis and management of ectopic pregnancy help prevent major morbidity and mortality in the first trimester. While studies frequently describe the general locations of ectopic pregnancies, there is less emphasis specifically on left- versus right-sided dominance. Understanding the lateralization patterns could enhance diagnostic accuracy and treatment strategies, thereby reducing the morbidity and mortality associated with this condition. We investigated the lateralisation patterns of ectopic pregnancies and to investigate any significant patterns associated with the ectopic side.

Materials and methods: This was a hospital-based, retrospective analytical cohort study conducted at the tertiary care hospital of North India from January 2021 to July 2024. The primary objective of the study was to determine the laterality of ectopic pregnancies.

Results: Among the 202 cases, 130 (64.4%) ectopic pregnancies were located in the right fallopian tube, whereas 72 (35.6%) cases were in the left fallopian tube (P < 0.0001). Among the 84 pregnancies that were found to have ruptured at diagnosis, 44.4% of the left-sided pregnancies ruptured, whereas 39.2% of the right-sided pregnancies ruptured (P < 0.47). A greater incidence of corpus luteum on the contralateral side was observed in the left-sided ectopic group (7.2% vs. 1.6% for the right-sided ectopic group, P < 0.001). The majority (99.8%) of the right-sided ectopic pregnancies had corpus luteum documented on the right side; however, only 86.1% of the left-sided pregnancies had a left-sided corpus luteum.

Conclusion: Our findings suggest a notable predominance of occurrences on the right side. This can aid clinicians in earlier diagnosis, better diagnostic vigilance and decision-making, including surgical planning, and an overall efficient utilization of healthcare resources.