Undiagnosed Ectopic Pregnancy: A Retrospective Analysis of 31 ‘Missed’ Ectopic Pregnancies at a Teaching Hospital

Background: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies in a tertiary care teaching hospital.Methods: This was a prospective study of 50 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from August 2012 to September 2013. Relevant data of the 50 patients was tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 6.3 per 1000 deliveries. Majority of the patients (82%) belonged to 20-30 yrs age group. 70% of the women were multiparous. The commonest site of ectopic pregnancy was fallopian tube (92 %). Past history of pelvic inflammatory disease (40%), abortions (20%), abdominopelvic surgery (14%) and IUCD usage (12%) were among the important risk factors identified. 20% of the patients had no identifiable risk factor. The classical triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 56 % of the study population. The most important signs which guided the diagnosis of ectopic pregnancy were cervical excitation pain (74%), abdominal tenderness (72%), adnexal mass or fullness (68%) and tenderness in the fornix (68%). Clinical presentation, urinary pregnancy test, culdocentesis and ultrasound were the diagnostic tools used for diagnosis of ectopic pregnancy. The incidence of ruptured ectopic pregnancy was 86%. Majority of the patients underwent salpingectomy (96%). There was no maternal mortality in our study.Conclusions: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.

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Laparoscopic Management of Ectopic Pregnancy at Birat Medical College & Teaching Hospital, Morang, Nepal

Birat Journal of Health Sciences ◽

10.3126/bjhs.v2i1.17285 ◽

2017 ◽

Vol 2 (1) ◽

pp. 106-109

Author(s):

Bhanubhakta Neupane ◽

GMS Karki ◽

P Dahal ◽

SB Karki

Keyword(s):

Ectopic Pregnancy ◽

Teaching Hospital ◽

College Teaching ◽

First Trimester ◽

Cross Sectional Study ◽

Cross Sectional ◽

Laparoscopic Management ◽

Medical College ◽

Life Threatening ◽

Ectopic Pregnancies

IntroductionEctopic pregnancy is the most life threatening emergency in first trimester of pregnancy. Laparoscopic methods for treating ectopic pregnancy have made it preferred surgical technique over laparotomy. Most of the ectopic pregnancies can now be treated by laparoscopy.ObjectiveTo study outcome of laparoscopic management of ectopic pregnancy. MethodologyA hospital based cross-sectional study was conducted at Birat Medical College and Teaching hospital from May 2013 to April 2016. The informed consent was taken from patients. The collected data was entered in Microsoft Excel and analyzed SPSS.ResultsAll 89 cases of ectopic pregnancies were managed by laparoscopy. All were tubal pregnancies. Salpingectomy was done in 88 cases and salpingostomy in one case without any significant postoperative complications. There was no maternal mortality and no conversion to laparotomy ConclusionTreatment of ectopic pregnancy by laparoscopy is effective with decreased postoperative morbidity.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, page: 106-109

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Risk factors, clinical presentation and management of ectopic pregnancy in a rural tertiary care centre- An observational study

Indian Journal of Obstetrics and Gynecology Research ◽

10.18231/j.ijogr.2021.064 ◽

2021 ◽

Vol 8 (3) ◽

pp. 296-300

Author(s):

Lopamudra B John ◽

Lingampalli Naga Saketha ◽

Setu Rathod

Keyword(s):

Risk Factors ◽

Observational Study ◽

Ectopic Pregnancy ◽

Teaching Hospital ◽

Surgical Intervention ◽

Tertiary Care ◽

Age Group ◽

Tertiary Care Teaching Hospital ◽

History Of ◽

Ectopic Pregnancies

: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the risk factors, clinical features at presentation, diagnostic tools, management modalities and outcome of ectopic pregnancies in a tertiary care teaching hospital.: This was an observational study of 90 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from February 2019 to August 2020. Relevant data of the 90 patients was tabulated and descriptive analysis was done. : Chi square and Fischer exact test: Majority of the patients belonged to 21-30 yrs age group. Maximum number of cases (57%) had a history of previous abdomino pelvic surgery. The predominant symptom was amenorrhea (96.6%) and classical triad of amenorrhea, bleeding per vagina and abdominal pain was seen in 30% of the study population. Majority of the patients i.e 76.7% underwent surgical intervention.: Most common age group at presentation is 21-30years. History of previous abdominal surgery being the most important risk factor whereas amenorrhea was the most common symptom. Surgical intervention was the main mode of management in ruptured ectopic pregnancy.

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Usefulness of endoscopic ultrasound and complication rate in a newly established tertiary care university-affiliated teaching hospital – retrospective analysis of the last 4 years

10.1055/s-0039-1691884 ◽

2019 ◽

Author(s):

M Razpotnik ◽

S Bota ◽

G Essler ◽

J Weber-Eibel ◽

M Peck-Radosavljevic

Keyword(s):

Retrospective Analysis ◽

Teaching Hospital ◽

Endoscopic Ultrasound ◽

Complication Rate ◽

Tertiary Care

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BH06 (P65): Retrospective analysis of the safety and appropriate use of 2,3‐diphenylcyclopropenone in alopecia in a university teaching hospital

British Journal of Dermatology ◽

10.1111/bjd.20185 ◽

2021 ◽

Vol 185 (S1) ◽

pp. 82-82

Keyword(s):

Retrospective Analysis ◽

Teaching Hospital ◽

University Teaching ◽

Appropriate Use

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ECTOPIC PREGNANCY SOCIAL MEDIA SUPPORT: AN ANALYSIS OF CONTENT AND ACCURACY OF FACEBOOK GROUPS FOR WOMAN EXPERIENCING ECTOPIC PREGNANCIES

Fertility and Sterility ◽

10.1016/j.fertnstert.2021.05.059 ◽

2021 ◽

Vol 116 (1) ◽

pp. e38-e39

Author(s):

Kaleigh A. Russell ◽

Roselyn Tran ◽

Mallory Stuparich ◽

Samar Nahas ◽

Sadikah Behbehani

Keyword(s):

Social Media ◽

Ectopic Pregnancy ◽

Ectopic Pregnancies

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Utility of a routine ultrasound for detection of ectopic pregnancies among women requesting abortion: a retrospective review

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2020-200888 ◽

2020 ◽

pp. bmjsrh-2020-200888

Author(s):

Clara I Duncan ◽

John J Reynolds-Wright ◽

Sharon T Cameron

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Clinical Care ◽

Significant Risk ◽

Intrauterine Pregnancy ◽

Retrospective Case ◽

Case Record ◽

Ultrasound Findings ◽

Ectopic Pregnancies ◽

Record Review

IntroductionRoutine ultrasound may be used in abortion services to determine gestational age and confirm an intrauterine pregnancy. However, ultrasound adds complexity to care and results may be inconclusive, delaying abortion. We sought to determine the rate of ectopic pregnancy and the utility of routine ultrasound in its detection, in a community abortion service.MethodsRetrospective case record review of women requesting abortion over a 5-year period (2015–2019) with an outcome of ectopic pregnancy or pregnancy of unknown location (PUL) at a service (Edinburgh, UK) conducting routine ultrasound on all women. Records were searched for symptoms at presentation, development of symptoms during clinical care, significant risk factors and routine ultrasound findings.ResultsOnly 29/11 381 women (0.25%, 95% CI 0.18%, 0.33%) had an ectopic pregnancy or PUL (tubal=18, caesarean scar=1, heterotopic=1, PUL=9). Eleven (38%) cases had either symptoms at presentation (n=8) and/or significant risk factors for ectopic pregnancy (n=4). A further 12 women developed symptoms during their clinical care. Of the remaining six, three were PUL treated with methotrexate and three were ectopic (salpingectomy=2, methotrexate=1). In three cases, the baseline ultrasound indicated a probable early intrauterine pregnancy.ConclusionsEctopic pregnancies are uncommon among women presenting for abortion. The value of routine ultrasound in excluding ectopic pregnancy in symptom-free women without significant risk factors is questionable as it may aid detection of some cases but may provide false reassurance that a pregnancy is intrauterine.

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Heterotopic pregnancy; case report

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v7i05.425 ◽

2019 ◽

Vol 7 (05) ◽

Author(s):

Vipul R. Khandagale

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Adnexal Mass ◽

Heterotopic Pregnancy ◽

Free Fluid ◽

Threatening Condition ◽

Life Threatening ◽

Ectopic Pregnancies ◽

High Index Of Suspicion ◽

Low Risk Women

Heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. It can be a life threatening condition and easily missed with the diagnosis. We present the case of a 37 year old patient who was treated for a heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.It is difficult to estimate exactly the incidence of ectopic pregnancies, but on an average it is approximately 1:300 normal pregnancies worldwide.

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