Ectopic Pregnancy: Extrauterine Pregnancy and Pregnancy of Unknown Location

2020 ◽  
pp. 9-26
Author(s):  
Peer Jansen ◽  
Ibrahim Alkatout
Keyword(s):  
Ectopic Pregnancy ◽  
Extrauterine Pregnancy ◽  
Pregnancy Of Unknown Location

Role of Serum β-HCG doubling in Diagnosis of Early Pregnancy and its Management Strategy

2020 ◽  
Vol 16 ◽  
Author(s):  
Divya Mirji ◽  
Shubha Rao ◽  
Akhila Vasudeva ◽  
Roopa P.S
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Management Strategy ◽  
Transvaginal Ultrasound ◽  
Expectant Management ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Β Hcg ◽  
Pregnancy Of Unknown Location

Background: Pregnancy of unknown location (PUL) is defined as the absence of intrauterine or extrauterine sac and Beta Human Chorionic Gonadotropin levels (β-HCG) above the discriminatory zone of 1500 mIU/ml. It should be noted that PUL is not always an ectopic; however, by measuring the trends of serum β-HCG, we can determine the outcome of a PUL. Objective: This study aims to identify the various trends β-HCG levels in early pregnancy and evaluate the role of β-HCG in the management strategy. Methods: We conducted a prospective observational study of pregnant women suspected with early pregnancy. Cases were classified as having a pregnancy of unknown location (PUL) by transvaginal ultrasound and ß-HCG greater than 1000 mIU/ml. Expectant management was done until there was a definite outcome. All the collected data were analyzed by employing the chi-square test using SPSS version 20. Results: Among 1200 women who had early first trimester scans, 70 women who fulfilled our criteria of PUL and ß-HCG > 1000 mIU/ml were recruited in this study. In our study, the mean age of the participants was 30±5.6yrs, and the overall mean serum ß-HCG was 3030±522 mIU/ml. The most common outcome observed was an ectopic pregnancy, 47% in our study. We also found the rate of failing pregnancy was 27%, and that of intrauterine pregnancy (IUP) was 25%. Overall, in PUL patients diagnosed with ectopic pregnancy, 9% behaved like IUP, and 4% had an atypical trend in their ß-HCG. Those who had an IUP, 11% had a suboptimal increase in ß-HCG. Conclusion: PUL rate in our unit was 6%. Majority of the outcome of PUL was ectopic in our study. Every case of PUL should be managed based on the initial ß-HCG values, clinical assessments and upon the consent of the patient.

scholarly journals Vaginal Microbiota Characteristics of Pregnancy of Unknown Location Women in China(VMCPULW): Study Protocol for a Prospective Cohort

2021 ◽  
Author(s):  
Xuge Huang ◽  
Yingxuan Zhang ◽  
Dongying Wang ◽  
Huimin Zhang ◽  
Si Chen ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Doppler Ultrasound ◽  
Color Doppler ◽  
Color Doppler Ultrasound ◽  
Vaginal Microbiota ◽  
Clinical Trial Registry ◽  
Multicenter Cohort Study ◽  
Β Hcg ◽  
Hcg Test ◽  
Pregnancy Of Unknown Location

Abstract Background: Pregnancy of unknown location (PUL) is a kind of pregnancy that has a positive beta-human chorionic gonadotropin (β-hCG) test result but the location of pregnancy cannot be determined by ultrasound. Early determination of the location of the pregnancy is important for subsequent treatment. However, there is no study on the characteristics of vaginal microbiota in pregnant women with unknown locations and a model for judging it by vaginal microbiota combined with clinical indicators. Therefore, we designed this study to compare the characteristics of vaginal microbiota in intrauterine and ectopic pregnancy populations during pregnancy with unknown locations and to establish a prediction model for pregnancy locations in PUL populations with clinical indicators.Methods: This is a prospective, multicenter cohort study. 576 eligible participants will be included in this study. Vaginal microbiota was collected from all participants at inclusion, and color Doppler ultrasound was performed weekly. After the locations of pregnancy were determined, participants of intrauterine pregnancy were followed up to their early pregnancy outcome, and participants of ectopic pregnancy were followed up until a none-pregnancy level of β-hCG was confirmed. Discussion: The regular method of judging the location of pregnancy is by color Doppler ultrasound and β-hCG test. We hope to provide earlier clinical methods of prediction for women with unknown locations of pregnancy through this study.Trial registration: Chinese Clinical Trial Registry: ChiCTR2000035378, registration date: 9 August 2020. http://www.chictr.org.cn/index.aspx

scholarly journals Methotrexate or expectant management in women with an ectopic pregnancy or pregnancy of unknown location and low serum hCG concentrations? A randomized comparison

2012 ◽  
Vol 28 (1) ◽  
pp. 60-67 ◽  
Author(s):  
N. M. van Mello ◽  
F. Mol ◽  
H. R. Verhoeve ◽  
M. van Wely ◽  
A. H. Adriaanse ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Expectant Management ◽  
Pregnancy Of Unknown Location ◽  
Low Serum

scholarly journals ECTOPIC PREGNANCY;

2012 ◽  
Vol 19 (02) ◽  
pp. 242-245
Author(s):  
ROBINA ALI ◽  
Uzma AFZAL
Keyword(s):  
Early Diagnosis ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Study Design ◽  
Medical Management ◽  
Surgical Intervention ◽  
Resolution Time ◽  
Safe Alternative ◽  
Extrauterine Pregnancy ◽  
Medical College

Objectives: To assess the effectiveness of systemic methotrexate for treatment of unruptured ectopic pregnancy. Introduction:Ectopic Pregnancy is pregnancy that occurs in any location other than the uterus. 95% to 98% are tubal ectopics, but the number of ovarian,abdominal and cervical implantations is rising as does the number of heterotopic pregnancies. Study Design: Prospective experimental study.Setting: DHQ Hospital affiliated with Punjab Medical College Faisalabad. Period: Jan-2009 to Dec-2009. Patient & Method: A total of 45women were admitted with diagnosis of extrauterine pregnancy. But only 10 women fulfilled the criteria for medical management. Out of these80% patients required no surgical intervention. However 20% needed surgery. 60% patients suffered from lower abdominal or pelvic pain. 20%required 2nd dose of methotrexate. Average ß-hCG resolution time was 35 days. Conclusions: With early diagnosis and proper selectioncriteria adoption, medical treatment of ectopic pregnancy with systemic methotrexate is an effective and safe alternative to surgicalinterventions.

scholarly journals Pregnancy of unknown location: outcome in a tertiary care teaching hospital

2017 ◽  
Vol 6 (7) ◽  
pp. 2787
Author(s):  
A. Shanti Sri ◽  
P. Kalpana
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Tertiary Care ◽  
Expectant Management ◽  
Transvaginal Sonography ◽  
Intrauterine Pregnancy ◽  
Care Teaching ◽  
Asymptomatic Patients ◽  
Pain Outcome ◽  
Pregnancy Of Unknown Location

Background: A pregnancy of unknown location (PUL) is a descriptive term used to classify a woman when she has a positive pregnancy test but no intra- or extra-uterine pregnancy is visualized on transvaginal sonography. The objective of present study was to find out the outcome of women with pregnancy of unknown location presenting to a tertiary care teaching hospital.Methods: The prospective study was conducted from from 1st October 2015 to 31st September 2016, to antenatal out-patient department, at Princess Esra Hospital, Deccan College of medical sciences, Hyderabad. Data was collected for women with early pregnancy or with history of amenorrhea, bleeding or pain. These women were investigated with serum beta-human chorionic gonadotrophin levels at interval of 48 hrs and transvaginal ultrasonography. Expectant management was done for failing pregnancy of unknown location while medical or surgical management was considered for persistent pregnancy of unknown location and ectopic pregnancy.Results: During study period, 9210 patients were admitted, and, of them, 960 (10.42%) were patients with early pregnancy. Meeting the inclusion criteria were 112 (11.6%) patients who formed the study sample. There were 104 (92.85%) patients presenting with amenorrhea, 98 (87.5%) had bleeding and 78 (69.64%) presented with pain. Outcome of 42 (48.83%) patients was failing pregnancy, 31 (36.04%) had intrauterine pregnancy, 8 (9.3%) converted to ectopic pregnancy, while 5 (5.81%) had persistent pregnancy of unknown location. All patients with persistent pregnancy of unknown location and 3 patients with ectopic pregnancy were medically treated. Three patients having an ectopic pregnancy were managed surgically.Conclusions: Management of choice for asymptomatic patients having pregnancy of unknown location is expectant management. Most of the patients suspected to have PUL resolved either into F-PUL or IUP with expectant management.

scholarly journals A rare case report: heterotopic pregnancy with ovarian ectopic pregnancy

2018 ◽  
Vol 7 (3) ◽  
pp. 1243
Author(s):  
Manuja N. ◽  
Ashok Devoor ◽  
Umashankar .
Keyword(s):  
Ectopic Pregnancy ◽  
Rare Case ◽  
Heterotopic Pregnancy ◽  
Missed Abortion ◽  
Extrauterine Pregnancy ◽  
Pain Abdomen ◽  
Rare Case Report ◽  
Reproductive Techniques ◽  
Natural Conception ◽  
High Index Of Suspicion

Heterotopic Pregnancy(HP) is defined as the occurrence of intrauterine and extrauterine pregnancy simultaneously. Incidence varies from 1 in 8000 to 30,000 natural conceptions. HP is common with artificial reproductive techniques and is very rare in natural conception. A high index of suspicion is helpful in diagnosis and appropriate management. We report a case of HP in a 28-year-old woman presented with 2 and half months amenorrhoea, pain abdomen and bleeding per vagina with TAS showing intra uterine single missed abortion and ovarian ectopic pregnancy.

scholarly journals Biomarkers for ectopic pregnancy and pregnancy of unknown location

2013 ◽  
Vol 99 (4) ◽  
pp. 1107-1116 ◽  
Author(s):  
Suneeta Senapati ◽  
Kurt T. Barnhart
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Of Unknown Location
Sign in / Sign up

Export Citation Format

Share Document