Hemodynamic havoc: complicated ectopic pregnancy may trigger acute kidney injury

Background: The incidence of complicated ectopic pregnancies highlights the need for awareness of risk factors, as well as associated morbidity and mortality. This study aimed to determine the incidence of acute kidney injury (AKI) in patients with complicated ectopic pregnancy and to assess associated morbidity and mortality. Methods: A retrospective observational study evaluated the incidence of AKI in patients with complicated ectopic pregnancy and assessed related morbidity and mortality at hospitals in Prayagraj, UP, from January 1, 2010, to December 31, 2024. Results: A total of 180 ectopic pregnancies (EPs) were diagnosed, comprising 70 (38.89%) cases in primiparous and 110 (61.11%) in multiparous females. EP locations included tubular (83.8%), cervical (1.11%), ovarian (0.005%), and cesarean scar (14.44%), with an observed increase in cesarean scar implantations. Prior to admission to the nephrology intensive care unit (nephro ICU), salpingectomy was performed in 83.88% of cases, hysterectomy in 14.45%, and subtotal hysterectomy in 1.67%. In addition to severe haemorrhage, primary clinical findings were shock, septicemia, acute respiratory distress syndrome, oliguria, and multiple organ failure. Renal replacement therapy was initiated in 65 patients; among these, 46 (71.5%) received haemodialysis and 19 (15.84%) underwent plasmapheresis. The occurrence of these complications, particularly those necessitating RRT, was associated with a poor prognosis. Conclusions: Early diagnosis of ectopic pregnancy reduces complications, morbidity, and mortality. Patients recovering from AKI must follow up with nephrology to ensure long-term health. Public awareness and training healthcare professionals in ultrasound for early detection are essential.