Case of a chronic ectopic pregnancy misdiagnosed as pelvic inflammatory disease

2021 ◽  
Vol 14 (1) ◽  
pp. e237053
Author(s):  
Hashviniya Sekar ◽  
Olga Divakova ◽  
Tanya Alan ◽  
Gregory Premetis
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Preoperative Diagnosis ◽  
Clinical Symptoms ◽  
Delayed Diagnosis ◽  
Uterine Fibroids ◽  
Diagnostic Dilemma ◽  
Clinical Presentations ◽  
Definition Of

The definition of a chronic ectopic pregnancy (CEP) is poorly defined in the literature and making a timely diagnosis can be incredibly challenging. This is primarily due to its broad range of clinical presentations and conflicting biochemical and sonographic results. Often, CEPs are mistaken for ovarian malignancies, pelvic inflammatory disease (PID), uterine fibroids or endometriosis, therefore, leading to a delayed diagnosis. We present a case report of a woman who was initially misdiagnosed with PID and then later preoperatively diagnosed with a CEP. This case particularly highlights the diagnostic dilemma posed by CEPs and raises awareness of the key clinical symptoms, biochemical and sonographic investigations which in combination can contribute towards making a timely preoperative diagnosis.

scholarly journals ECTOPIC PREGNANCY

2011 ◽  
Vol 18 (01) ◽  
pp. 24-27
Author(s):  
AFROZA ABBAS ◽  
H. AKRAM
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
International Studies ◽  
Reproductive Health Care ◽  
Nulliparous Women ◽  
Causative Factors ◽  
Contraceptive Utilization ◽  
Labour Room ◽  
Timely Referral

Objective: To find out the causative factors for rising rate of ectopic pregnancy in young women at periphery. Design: Descriptive study. Place and Duration of Study: Maula Bakhsh Teaching Hospital ( Obstetrical and gynaecological unit) Sargodha , from January 2008 – December 2008. Patients and Methods: All patients who were presented in labour room emergency and gynaecological out patients department with confirmed diagnosis of ectopic pregnancy on USG were included in the study. A pre-formed proforma was used to record the details about the demographic features, pre-existing risk factors for ectopic pregnancy, clinical features at presentation and management. Results: Frequency of ectopic pregnancy was too high in our study compared to international studies. Majority of patients were young and nullipara. Leading risk factor is pelvic inflammatory disease due to septic induced abortion. 92% of patients had acute presentation. Conclusions: Rising rate of ectopic pregnancy was found in young, nulliparous women secondary to pelvic inflammatory disease. The frequency can be reduced by awareness of reproductive health care, liberal contraceptive utilization, acceptable adequate planned family. Early diagnosis and timely referral may be helpful in treating the patients prior to tubal rupture with decreased morbidity and mortality.

scholarly journals Ten years transmission of the new variant of Chlamydia trachomatis in Sweden: prevalence of infections and associated complications

2017 ◽  
Vol 94 (2) ◽  
pp. 100-104 ◽  
Author(s):  
Jenny Dahlberg ◽  
Ronza Hadad ◽  
Karin Elfving ◽  
Inger Larsson ◽  
Jenny Isaksson ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Complication Rates ◽  
Becton Dickinson ◽  
Specific Pcr ◽  
Single Target ◽  
New Variant ◽  
Low Prevalence

ObjectivesIn 2006, a new variant of Chlamydia trachomatis (nvCT) was discovered in Sweden. It has a deletion in the plasmid resulting in failed detection by the single target systems from Abbott and Roche used at that time, whereas the third system used, from Becton Dickinson (BD), detects nvCT. The proportion of nvCT was initially up to 65% in counties using Abbott/Roche systems. This study analysed the proportion of nvCT from 2007 to 2015 in four selected counties and its impact on chlamydia-associated complications.MethodsC. trachomatis-positive specimens collected from 2007 to 2015 were analysed by a specific PCR to identify nvCT cases. Genotyping was performed by multilocus sequence typing (MLST) and ompA sequencing. Ectopic pregnancy and pelvic inflammatory disease records were extracted from the national registers.ResultsIn total, 5101 C. trachomatis-positive samples were analysed. The nvCT proportion significantly decreased in the two counties using Roche systems, from 56% in 2007 to 6.5% in 2015 (p<0.001). In the two counties using BD systems, a decrease was also seen, from 19% in 2007 to 5.2% in 2015 (p<0.001). Fifteen nvCT cases from 2015 and 102 cases from 2006 to 2009 had identical MLST profiles. Counties using Roche/Abbott systems showed higher mean rates of ectopic pregnancy and pelvic inflammatory disease compared with counties using BD systems.ConclusionsThe nvCT proportion has decreased in all counties and converged to a low prevalence irrespective of previous rates. Genotyping showed that nvCT is clonal and genetically stable. Failing detection only marginally affected complication rates.

Pelvic inflammatory disease

2020 ◽  
pp. 536-549
Author(s):  
Gillian Dean ◽  
Jonathan Ross
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Severe Disease ◽  
Lower Abdominal Pain ◽  
Asymptomatic Infection ◽  
Public Understanding ◽  
Transmitted Infection ◽  
Delay In Diagnosis ◽  
Sexually Transmitted

Pelvic inflammatory disease is a sexually transmitted infection of the female upper genital tract. Rates of pelvic inflammatory disease have fallen in many countries over the last 10 years, at least in part due to increased screening for chlamydial infection. The clinical spectrum ranges from asymptomatic infection through to severe disease requiring hospitalization. Due to the non-specific nature of the condition, diagnosis can be challenging. All sexually active women presenting with acute lower abdominal pain should have a pregnancy test to rule out ectopic pregnancy. Treatment must be initiated as soon as the diagnosis is suspected and include antibiotics covering a broad spectrum of pathogens. Delay in diagnosis increases the risk of adverse sequelae including ectopic pregnancy and infertility. It is recommended that current and recent sexual partners receive empirical treatment, regardless of symptoms or microbiological results, and refrain from sexual contact until completion of therapy. Through better public understanding of the symptoms of pelvic inflammatory disease, women seeking earlier medical attention may reduce the risk of reproductive damage.

scholarly journals Pelvic inflammatory disease and the risk factors

2018 ◽  
Vol 7 (9) ◽  
pp. 3572
Author(s):  
V. G. Vanamala ◽  
Sushil Pakyanadhan ◽  
Aruna Rachel ◽  
Sudeep Abraham P.
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Clinical Symptoms ◽  
Economic Status ◽  
Uterine Cavity ◽  
Lower Class ◽  
Gynecological Disorders ◽  
Multiple Partners ◽  
Ascending Infection ◽  
Education Levels

Background: Pelvic inflammatory disease is one of the most common gynecological disorders of women. It is a clinical condition where in the endometrial, fallopian tubes and the adjacent pelvic structures are infected due to the ascending infection from the lower genital tract such as vagina and cervix through the uterine cavity leading to severe morbidity.Methods: 150 non-pregnant women who came in with clinical symptoms suggestive of Pelvic inflammatory disease and diagnosed as acute pelvic infection or PID were included in the study. Demographic details such as age, weight, height, parity, socio-economic status, education levels etc were noted.Results: 54% of them belonged to 26-30 years age group, followed by 19.3% of women between 20-25 years. 35.3% of the patients were illiterate followed by primary school education in 29.3%. 74% of the patients belonged to the lower class while 24.7% were from the middle class. Condoms were the most common contraceptive method used in 32% of the cases, while 27.3% of the patients used intrauterine devices.Conclusions: Proper education must be given regarding the hazards of early marriages lack of hygiene, and to abstain from multiple partners, to the women especially those from the lower socioeconomic strata.

scholarly journals Chlamydia trachomatis and the Risk of Pelvic Inflammatory Disease, Ectopic Pregnancy, and Female Infertility: A Retrospective Cohort Study Among Primary Care Patients

2019 ◽  
Vol 69 (9) ◽  
pp. 1517-1525 ◽  
Author(s):  
Casper D J den Heijer ◽  
Christian J P A Hoebe ◽  
Johanna H M Driessen ◽  
Petra Wolffs ◽  
Ingrid V F van den Broek ◽  
...  
Keyword(s):  
Chlamydia Trachomatis ◽  
Reproductive Health ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Antibiotic Use ◽  
Female Infertility ◽  
Dependent Manner ◽  
Increased Risk ◽  
Ct Test

Abstract Background We evaluated the risk of pelvic inflammatory disease (PID), ectopic pregnancy, and infertility in women with a previous Chlamydia trachomatis (CT) diagnosis compared with women who tested negative for CT and CT untested women, considering both targeted and incidental (ie, prescribed for another indication) use of CT-effective antibiotics. Methods This was a retrospective study of women aged 12–25 years at start of follow-up within the Clinical Practice Research Datalink GOLD database linked to index of multiple deprivation quintiles, 2000–2013. CT test status and antibiotic use were determined in a time-dependent manner. Risk of PID, ectopic pregnancy, or female infertility were evaluated using of Cox proportional hazard models. Results We studied 857 324 women, contributing 6 457 060 person-years. Compared with women who tested CT-negative, women who tested CT-positive had an increased risk of PID (adjusted hazard ratio [aHR], 2.36; 95% confidence interval [CI], 2.01–2.79), ectopic pregnancy (aHR, 1.87; 95% CI, 1.38–2.54), and infertility (aHR, 1.85; 95% CI, 1.27–2.68). The PID risk was higher for women with 2 or more positive CT tests than those with 1 positive test. PID risk increased with the number of previous antibiotic prescriptions, regardless of CT test status. Conclusions We showed an association between CT-positive tests and 3 adverse reproductive health outcomes. Moreover, this risk increased with repeat CT infections. CT-effective antibiotic use showed no decreased risks of subsequent PID regardless of CT history. Our results confirm the reproductive health burden of CT, which requires adequate public health interventions.

CA 125 in Benign Gynecological Conditions

1998 ◽  
Vol 13 (4) ◽  
pp. 231-237 ◽  
Author(s):  
H. Meden ◽  
A. Fattahi-Meibodi
Keyword(s):  
Tumor Marker ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Cirrhosis Of The Liver ◽  
Ca 125 ◽  
Ovarian Cysts ◽  
Gynecological Tumors ◽  
Ovarian Abscess

The tumor marker CA 125 was initially thought to be specific for ovarian malignancies. Subsequently it was found to be raised in a variety of benign conditions, including pregnancy, pelvic inflammatory disease, tuberculosis and cirrhosis of the liver. With respect to gynecological tumors, CA 125 may be elevated in benign ovarian cysts, tubo-ovarian abscess, endometriosis, hyperstimulation syndrome, ectopic pregnancy and fibroids. These results demonstrate that CA 125 is a marker of non-specific peritoneal conditions.

scholarly journals Clinico-Ultrasonographic Profile of Ectopic Pregnancy in Western Nepal

2018 ◽  
Vol 8 (1) ◽  
pp. 2-6
Author(s):  
Sangeeta Devi Gurung ◽  
Prakash Sharma
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Radiological Finding ◽  
Previous History ◽  
First Trimester ◽  
Reproductive Age ◽  
Age Group ◽  
Type Iii ◽  
Reproductive Age Group

Introduction: Ectopic pregnancy (EP) is one of the major complications in first trimester pregnancy, resulting in increased maternal morbidity and mortality. It accounts for 1.3-2.4% of all pregnancies. Previously, though laparoscopy was considered as the gold standard for diagnosis of ectopic pregnancy, due to availability of high resolution ultrasound, it has become the first line investigation for the diagnosis of ectopic pregnancy.Methods: It is a prospective study conducted in Manipal Teaching Hospital, Pokhara, from January 2015 till December 2017. All the cases diagnosed with ectopic pregnancy were included in the study.  Ultrasonological and intraoperative findings were recorded. Data was analyzed using SPSS (VERSION 16).Results: Twenty six patients were diagnosed with ectopic pregnancies. The incidence was 0.35%. It was most common among the reproductive age group between 20-40 years with mean age of 30.50 years. Pelvic inflammatory disease (n=10, 38.5%) was considered as risk factor. Radiological finding of Type III ectopic pregnancy (n=21, 80.8%) was the most common type.Conclusion: Ectopic pregnancy is common among reproductive age group with previous history of pelvic inflammatory disease. Type III is the most common type.

scholarly journals Chlamydia Public Health Programs and the Epidemiology of Pelvic Inflammatory Disease and Ectopic Pregnancy

2012 ◽  
Vol 207 (1) ◽  
pp. 30-38 ◽  
Author(s):  
Michael L. Rekart ◽  
Mark Gilbert ◽  
Rafael Meza ◽  
Paul H. Kim ◽  
Michael Chang ◽  
...  
Keyword(s):  
Public Health ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Health Programs ◽  
Public Health Programs

Miscellaneous topics in gynaecology

2016 ◽  
Author(s):  
Stergios K. Doumouchtsis ◽  
S. Arulkumaran ◽  
Maya Basu ◽  
Claudine Domoney ◽  
Stergios K. Doumouchtsis ◽  
...  
Keyword(s):  
Sexual Assault ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Urinary Retention ◽  
Genital Herpes ◽  
Inflammatory Disease ◽  
Emergency Surgery ◽  
Medical Management ◽  
Prophylactic Antibiotics

This chapter outlines miscellaneous topics in gynaecology, such as urinary retention, sexual assault (including incidence, risks, examination, and management), and pharmacotherapeutics in gynaecology (drugs used in the treatment of pelvic inflammatory disease (PID), prophylactic antibiotics for emergency surgery, genital herpes, menorrhagia and dysmenorrhoea, and medical management of ectopic pregnancy and miscarriage).

Ectopic Pregnancy in Nairobi, Kenya

1970 ◽  
Vol 15 (5) ◽  
pp. 172-175 ◽  
Author(s):  
C. A. Maley ◽  
S. Auma
Keyword(s):  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Pelvic Sepsis ◽  
National Hospital ◽  
Kenyatta National Hospital ◽  
High Incidence ◽  
Abdominal Operations

One hundred and nineteen cases of ectopic pregnancy treated in the Department of Gynaecology, Kenyatta National Hospital, Nairobi, are described. Ectopic pregnancy accounted for almost one third of the abdominal operations performed in the department. Pelvic inflammatory disease seemed to be the cause of this high incidence. Culdocentesis proved useful for diagnosis, but should be employed with caution in a population in whom pelvic sepsis is common. The value and safety of auto-transfusion is emphasised.

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