BEDSIDE TEST TO RULE OUT AN ECTOPIC PREGNANCY USING A MODIFIED FDA APPROVED KIT

Pregnancy implanted in the rudimentary horn of unicornuate uterus is very rare with an incidence of 1 in 75,000 to 1 in 150,000 pregnancies. Both prerupture and postrupture diagnosis of ectopic pregnancy in the rudimentary horn of a unicornuate uterus is difficult. Here is a case of a 21-year-old gravida 5 para 3 abortion 1 mother presented with abdominal pain of 2 days duration following a falling accident. The patient was severely anemic and was in hypovolemic shock at the time of presentation. She had diffused lower abdominal tenderness with hemoperitonium. After clinical and ultrasound evaluation, emergency laparotomy was decided for preop diagnosis of ruptured cornual ectopic pregnancy to rule out uterine rupture at gestational age of 16 weeks. Intraoperatively, ruptured ectopic pregnancy in noncommunicating rudimentary horn was diagnosed. Resection of rudimentary horn and ipsilateral salpingectomy was done. She was transfused with 5 units of compatible blood. It is better to increase awareness about pregnancy occurring in this rare uterine anomaly, so as to have a high index of suspicion as early detection before it gets ruptured is difficult.

Download Full-text

Ectopic pregnancy outcomes in patients discharged from the emergency department

CJEM ◽

10.1017/cem.2018.13 ◽

2018 ◽

Vol 21 (1) ◽

pp. 71-74

Author(s):

Krista Hawrylyshyn ◽

Shelley L. McLeod ◽

Jackie Thomas ◽

Catherine Varner

Keyword(s):

Emergency Department ◽

Ectopic Pregnancy ◽

Chart Review ◽

Transvaginal Ultrasound ◽

Tertiary Care ◽

Expectant Management ◽

Retrospective Chart Review ◽

Missed Abortion ◽

Ectopic Pregnancies ◽

Rule Out

AbstractObjectiveThe objective of this study was to determine the proportion of women who had a ruptured ectopic pregnancy after being discharged from the emergency department (ED) where ectopic pregnancy had not yet been excluded.MethodsThis was a retrospective chart review of pregnant (<12-week gestational age) women discharged home from an academic tertiary care ED with a diagnosis of ectopic pregnancy, rule-out ectopic pregnancy, or pregnancy of unknown location over a 7-year period.ResultsOf the 550 included patients, 83 (15.1%) had a viable pregnancy, 94 (17.1%) had a spontaneous or missed abortion, 230 (41.8%) had an ectopic pregnancy, 72 (13.1%) had unknown outcomes, and 71 (12.9%) had other outcomes that included therapeutic abortion, molar pregnancy, or resolution of βHCG with no location documented. Of the 230 ectopic pregnancies, 42 (7.6%) underwent expectant management, 131 (23.8%) were managed medically with methotrexate, 29 (5.3%) were managed with surgical intervention, and 28 (5.1%) patients had a ruptured ectopic pregnancy after their index ED visit. Of the 550 included patients, 221 (40.2%) did not have a transvaginal ultrasound during their index ED visit, and 73 (33.0%) were subsequently diagnosed with an ectopic pregnancy.ConclusionThese results may be useful for ED physicians counselling women with symptomatic early pregnancies about the risk of ectopic pregnancy after they are discharged from the ED.

Download Full-text

A life-threatening condition – ruptured ectopic pregnancy with negative urine pregnancy test: A case report

Malaysian Family Physician ◽

10.51866/cr1117 ◽

2021 ◽

Vol 16 (1) ◽

pp. 121-123

Author(s):

Fadzilah Mohamad ◽

Ahmad Shuib Yahya ◽

Aneesa Abdul Rashid ◽

Navin Kumar Devaraj ◽

Abdul Hadi Abdul Manap

Keyword(s):

Abdominal Pain ◽

Emergency Management ◽

Ectopic Pregnancy ◽

Case Reports ◽

Rare Occurrence ◽

Pregnancy Test ◽

Threatening Condition ◽

Life Threatening ◽

Rule Out ◽

Urine Pregnancy Test

Ectopic pregnancy is an extra-uterine pregnancy and is a potentially life-threatening condition that can lead to death from intra-peritoneal hemorrhage. This case reports a rare occurrence of ruptured tubal pregnancy in which the patient presented early with abdominal pain and a negative urine pregnancy test but subsequently presented again with evidence of intra-peritoneal hemorrhage. A negative urine pregnancy test is often used to rule out pregnancy, but it is not 100% sensitive. Complete assessment is critical in this important diagnosis in order to plan for the appropriate emergency management.

Download Full-text

Outcome of Patients with an Indeterminate Emergency Department First-trimester Pelvic Ultrasound to Rule Out Ectopic Pregnancy

Academic Emergency Medicine ◽

10.1197/j.aem.2004.03.017 ◽

2004 ◽

Vol 11 (9) ◽

pp. 912-917 ◽

Cited By ~ 6

Author(s):

V. S. Tayal

Keyword(s):

Emergency Department ◽

Ectopic Pregnancy ◽

First Trimester ◽

Pelvic Ultrasound ◽

Rule Out

Download Full-text

Touch Preps of Products of Conception for Rule-out Ectopic Pregnancy: A Viable Alternative to Frozen Section

Journal of the American Society of Cytopathology ◽

10.1016/j.jasc.2014.09.184 ◽

2014 ◽

Vol 3 (5) ◽

pp. S77

Author(s):

Drucilla Roberts ◽

Rosemary Tambouret

Keyword(s):

Ectopic Pregnancy ◽

Frozen Section ◽

Viable Alternative ◽

Products Of Conception ◽

Rule Out

Download Full-text

P067: Ectopic pregnancy outcomes in patients discharged from the emergency department

CJEM ◽

10.1017/cem.2018.265 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S80-S81

Author(s):

K. Hawrylyshyn ◽

S. McLeod ◽

J. Thomas ◽

C. Varner

Keyword(s):

Ectopic Pregnancy ◽

Chart Review ◽

Surgical Intervention ◽

Tertiary Care ◽

Expectant Management ◽

Retrospective Chart Review ◽

Missed Abortion ◽

Ectopic Pregnancies ◽

Pregnancy Of Unknown Location ◽

Rule Out

Introduction: The objective of this study was to determine the proportion of women who had a ruptured ectopic pregnancy after being discharged from the ED where ectopic pregnancy had not yet been excluded. Methods: This was a retrospective chart review of pregnant (<12 week gestational age) women discharged home from an academic tertiary care ED with a diagnosis of ectopic pregnancy, rule out ectopic pregnancy, or pregnancy of unknown location (PUL) over a 7 year period. Results: Of the 550 included patients, 83 (15.1%) had a viable pregnancy, 94 (17.1%) had a spontaneous or missed abortion, 230 (41.8%) had an ectopic pregnancy, 72 (13.1%) had unknown outcomes and 71 (12.9%) had other outcomes which included therapeutic abortion, molar pregnancy or resolution of HCG with no location documented. Of the 230 ectopic pregnancies, 42 (7.6%) underwent expectant management, 131 (23.8%) were managed medically with methotrexate, 29 (5.3%) were managed with surgical intervention, and 28 (5.1%) patients had a ruptured ectopic pregnancy after their index ED visit. Of the 550 included patients, 221 (40.2%) did not have a transvaginal US during their index ED visit, 73 (33.0%) were subsequently diagnosed with an ectopic pregnancy. Conclusion: These results may be useful for ED physicians counselling women with symptomatic early pregnancies about the risk of ectopic pregnancy after they are discharged from the ED.

Download Full-text

MANAGEMENT OF INFERTILITY DUE TO HYDROSALPINX WITH BOH BY AYURVEDIC REGIME: A CASE STUDY

November 2020 - International Ayurvedic Medical Journal ◽

10.46607/iamj2709022021 ◽

2021 ◽

Vol 9 (2) ◽

pp. 491-497

Author(s):

Poonam Kumari ◽

Hetal H. Dave ◽

Poonam Choudhary ◽

Sonu 4

Keyword(s):

Ectopic Pregnancy ◽

Female Child ◽

Corrective Surgery ◽

X Ray ◽

Preg Nancy ◽

Healthy Female ◽

History Of ◽

Diagnostic Investigations ◽

Rule Out

We report a case of a 33 years old female patient anxious for issues since 2 years. Patient was having Bad Obstetric History (BOH) in her previous 2 pregnancies with history of Ectopic pregnancy in her last preg-nancy for which linear salpingostomy was done. Patient underwent diagnostic investigations and proce-dures to rule out the cause. She was found to have Bilateral Hydrosalpinx in her HSG findings. So, the treatment was planned accordingly, and she was treated with Ayurvedic regimen consisting of Shodhana and Shamana therapy. HSG was repeated 6 months after treatment which was found to be normal with Bi-lateral patent tubes and she was managed to conceive successfully after treatment. Though she was a K/C/O BOH also, so she was provided all the necessary advice and examinations in her Antenatal period including Masanumasika Garbhini Paricharya and she delivered healthy female child of 2.8 kgs on 21.11.2020. So, implementation of Ayurvedic approach with X ray HSG resulted in successfully treating this case without tubal corrective surgery.

Download Full-text