scholarly journals Ectopic Pregnancy, Still A Life Threatening Emergency - A Clinical Study Of 100 Cases

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Kavitha B ◽  
Geetha L ◽  
Usha Rani T ◽  
Rama Devi A ◽  
Madhuri K ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Case Fatality ◽  
Common Life ◽  
Ectopic Gestation ◽  
Child Bearing ◽  
Life Threatening ◽  
Common Risk Factors ◽  
A Prospective Study ◽  
Urine Pregnancy Test

Ectopic pregnancy is still a major challenge & its incidence is on the rise due to changes in lifestyle & advances in medical practice. The objective was to study incidence, clinical presentation, risk factors & management of cases that presented in our hospital over a four -year period. A Prospective study of 100 cases presenting as ectopic pregnancy from 15-1-2010 to 15-1-2014.During this period total of 3176 deliveries & 1347 gynaecological surgeries were recorded. 100 patients had ectopic gestations accounting for 3.1% of all deliveries & 7.4% of gynaecological surgeries. Peak age group was 20-29y in 59cases(59%). Gestational age at presentation was 6-8weeks for most of the cases (62%). 59 cases (59%) were multiparous & 41(41%) were nulliparous. All had symptoms suggestive of ectopic pregnancy (amenorrhea, abdominal pain, giddiness, bleeding pervaginum). Diagnosis was confirmed by urine pregnancy test & USG. Common risk factors present were previous surgery ie LSCS-30(30%), Tubectomy-19(19%); Abortions-32(32%); Infertility-36(36%); PID-16(16%).Out of 100cases, 93 (93%) were ruptured & 7(7%) unruptured. Unruptured cases were treated medically using Methotrexate. Laparotomy was done for ruptured cases. Commonest site of Ectopic was ampulla (60%). Salpingectomy was done for most cases (73%).Although case-fatality has decreased, ruptured Ectopic gestation continues to be a common life-threatening emergency making tubal conservation inapplicable. This is of concern in a society with high premium on child-bearing.

scholarly journals Ectopic pregnancy at Soavinandriana hospital center, Antananarivo, Madagascar

2018 ◽  
Vol 6 (8) ◽  
pp. 2596
Author(s):  
Romuald Randriamahavonjy ◽  
Hary F. Rabarikoto ◽  
Fy N. A. T. Mahefarisoa ◽  
Tanjona A. Ratsiatosika ◽  
Hery R. Andrianampanalinarivo
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Reproductive Potential ◽  
First Trimester ◽  
Early Presentation ◽  
Induced Abortions ◽  
Life Threatening ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
A Prospective Study

Background: In the first trimester pregnancy, ectopic pregnancy is the most life-threatening gynecological emergency. The aim of this study was to estimate the epidemiological, diagnostic and therapeutic aspects of ectopic pregnancy in Antananarivo, Soavinandriana Hospital Center.Methods: This was a prospective study carried out among consecutive patients of ectopic pregnancy admitted from January 2014 to February 2016. All cases of diagnosed ectopic pregnancy admitted and managed in the gynecological ward were included in the study. These were reviewed and information was extracted regarding women characteristics, clinical features, diagnosis, management and post-operative complications.Results: During this period, there were 41 ectopic pregnancies. The incidence was therefore 20/1000 births. The mean age was 32,26years. The peak age of incidence was the 30-39 years age group. Nulliparous were the most sufferers. The commonest risk factors identified were previous genital infection. (n=17; 41,46%) previous induced abortions (n=15; 36,58%) and the age ≥35 years old (n =16; 39,02%). Twenty seven patients (n=11) did not have a quantitative measurement of the β subunit of human chorionic gonadotropin (β-hCG). Pelvic ultrasound (transabdominal) was performed on all patients. The majority of patients had a laparotomy (n=35, 85,36%). Tubal pregnancies were noted in 90% (n=37) cases.Conclusions: Health educations on early presentation in hospitals are expected to reduce the incidence of EP and the consequent loss of reproductive potential. The majority of risk factors we identified can be early detected and treated.

scholarly journals The role of risk factors in the incidence and recurrence of ectopic pregnancy

2021 ◽  
Vol 68 (1) ◽  
pp. 87-91
Author(s):  
Catalina Diana Stanica ◽  
◽  
Adrian Neacsu ◽  
Romina Marina Sima ◽  
Raluca Gabriela Ioan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Surgery ◽  
Ectopic Pregnancy ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Risk Of Recurrence ◽  
Life Threatening ◽  
Common Risk Factors ◽  
Control Study

The increase in the incidence of ectopic pregnancy in the last 20 years, with the serious compromise of the woman's obstetric future and the life-threatening complications caused by it, makes ectopic pregnancy a very current problem, frequently encountered in Obstetrics-Gynecology clinics The aim of this study is to compare how risk factors and management can influence the incidence and the risk of recurrence of ectopic pregnancy. This paper presents a prospective case-control study for 65 patients, who have been diagnosed serologically and ultrasonically. In the present study, the most common risk factors involved were: pelvic inflammatory disease (46%), ectopic pregnancy (20%), smoking (85%), abortions (55%), and abdominal surgery (43%). In the group of patients studied, patients required surgical and medical treatment, and also a management of expectation. The risk factors that influence recurrence were smoking (100%), pelvic inflammatory disease (84.6%), abortions (53.8%), abdominal surgery (46%). By the type of surgery (laparoscopy or laparotomy), the risk of recurrence varies between 6 and 10% and does not seem to be influenced by it.

Heterotopic pregnancy; case report

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.

scholarly journals Necrotising fasciitis caused by metastatic endometrial cancer: a rare cause of a life-threatening condition

2017 ◽  
Vol 99 (2) ◽  
pp. e72-e74
Author(s):  
S Hendrickson ◽  
N Bystrzonowski ◽  
C Kokkinos ◽  
P Butler
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Lumbar Spine ◽  
Endometrial Adenocarcinoma ◽  
Necrotising Fasciitis ◽  
Iliopsoas Muscle ◽  
Iliopsoas Abscess ◽  
Threatening Condition ◽  
Life Threatening ◽  
Common Risk Factors

We report a case of necrotising fasciitis caused by metastatic endometrial adenocarcinoma. Metastases to the lumbar spine with local invasion to the iliopsoas muscle led to an iliopsoas abscess, which subsequently progressed to necrotising fasciitis of the flank. This patient lacked common risk factors for necrotising fasciitis. There are no previous reports in the literature of necrotising fasciitis with this aetiology. We discuss the available evidence for aetiology of and risk factors for necrotising fasciitis, and the relation of time to surgery with prognosis.

scholarly journals Clinical presentation of tubal ectopic pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1148
Author(s):  
Kavitha Garikapati ◽  
M. Parvathi Devi ◽  
N. Alekya Goud
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Uterine Cavity ◽  
Expectant Management ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Child Bearing ◽  
Incidence Risk ◽  
Ectopic Pregnancies

Background: When the fertilized ovum gets implanted at site other than normal position of uterine cavity, it is known as ectopic pregnancy. Incidence of ectopic pregnancy is 1-2% of all reported pregnancies. It is an unmitigated disaster of human production and the most important cause of morbidity and mortality in first trimester with major cause of reduced child bearing potential. It is notorious in its clinical presentation, challenging the attending physician.Methods: women with risk factors, signs and symptoms and with confirmed diagnosis. Women discharged against medical advice. Study population is 50. Retrospective analysis for 3 years (2016-2019). Objectives of this study were to study the incidence, risk factors, clinical presentation, diagnosis and changing trends of modern management. Results analysed after entering the information in the excel sheets using descriptive analysisResults: Out of 4940 deliveries, 50 were tubal ectopic pregnancies 1.012%. Women aged 20-25 years were 52%. In our study, multiparous were 68%. Common symptoms were abdominal pain 80.2%, amenorrhea 72%, urine gravindex test positive 92.8%. Etiology was PID 20%, previous ectopic pregnancy 4%, IUCD 4%, LSCS with tubectomy 16%, most common site is ampulla 82%. About 78% were ruptured. Tubal abortions 4%, salpingectomy done in 82%. Laparotomy in 2.43% in hemodynamically unstable. Medical management 8%. Salpingostomy in 4% and expectant management 2%. Morbidity in the form of blood transfusion 23.48%, DIC with ICU admission 2%. No mortality.Conclusions: A high index of clinical suspicion with underlying risk factors may get us early diagnosis for timely intervention.

scholarly journals Stroke in Young Adults: A Prospective Study from Northwestern Nigeria

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
L. F. Owolabi ◽  
A. Ibrahim
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Prospective Study ◽  
Case Fatality ◽  
Northwestern Part ◽  
Cardiac Diseases ◽  
Stroke In Young Adults ◽  
Medical Wards ◽  
A Prospective Study ◽  
Stroke In Young

Background. Stroke is an important cause of morbidity and mortality in young adults especially in developing countries. This two-centre prospective study aimed at reviewing the pattern, types, and case fatality of stroke in the young adults in Northwestern part of Nigeria. Methods. Consecutive patients aged 18–40 years admitted to the medical wards of two tertiary hospitals from June 2008 to August 2010 were recruited. Relevant clinical data were obtained from the patients.The survivors were followed up in neurology clinics for 6 months. Results. A total of 71 patients aged 18–40 yrs, (mean age was ) comprising 52(73%) males and 19(23%) females were enrolled. Forty two (59.1%) patients had infarctive stroke. The risk factors included hypertension (74.7%) patients, smoking (50.7%), hypercholesterolemia (9.9%), non-hypertensive cardiac diseases (8.5%), HIV (8.5%), diabetes mellitus (4.2%) cocaine and amphetamine (2.8%), and sickle cell disease (2.8%). Only twelve (17%) patients presented within the first 6 hours of onset of stroke. Seventeen (23.9 %) patients died, case fatality in the first 24 and 72 hrs was 4.2% and 19.7%, respectively. Conclusion. Our data suggests that stroke in young adults is not as uncommon as previously suggested. Hypertension, smoking, hypercholesterolemia, cardiac diseases and HIV are the most common risk factors.

scholarly journals Feasibility of laparoscopy in management of ectopic pregnancy: experience from a tertiary care hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 1778
Author(s):  
Jyoti Meena ◽  
Richa Vatsa ◽  
Sunesh Kumar ◽  
Kallol K. Roy ◽  
Anshu Yadav ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Tertiary Care ◽  
Primary Objective ◽  
Diagnostic Methods ◽  
New Delhi ◽  
Care Hospital ◽  
Secondary Objective ◽  
A Prospective Study

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality. For surgical management, laparoscopy is preferred option. In developing world for ruptured ectopic pregnancy laparotomy is done at most of places. In this study we have assessed feasibility of laparoscopic management in both ruptured and unruptured ectopic pregnancy.Methods: A prospective study, conducted over period of 1 year from July 2014 to July 2015 in Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. In 110 patients of ectopic pregnancy parameters studied were age and parity, symptoms, risk factors, diagnostic methods, site of ectopic, management and its outcome. Primary objective was to evaluate management outcome of ectopic pregnancy and to assess feasibility of laparoscopy in ectopic pregnancy. Ruptured ectopic pregnancy with massive hemoperitoneum were analyzed separately. Secondary objective was to study demographic characters and risk factors of ectopic pregnancy.Results: Surgical management was required in 93.6% patients, out of which 86.4% were managed laparoscopically. Unruptured ectopic pregnancy was managed successfully by laparoscopy in 96.6% (29/30) patients. Ectopic was ruptured in 73 (66.3%) cases, laparoscopy was attempted in 91.7% (67/73). In 10.4% (7/67) patients laparoscopy had to be converted to laparotomy and it was successful in 89.5%. Out of 16 patients with massive hemoperitoneum, 12(75%) were managed laparoscopically. There was no mortality.Conclusions: In most of cases laparoscopy is safe and successful. Laparoscopy is feasible in ruptured ectopic cases including selected cases with massive hemoperitoneum thus avoiding unnecessary laparotomy and associated morbidity. Timely diagnosis and management prevents mortality.

scholarly journals Can I Be Pregnant? – Diagnostic Challenges in Ruptured Chronic Ectopic Pregnancy

2021 ◽  
Vol 16 (2) ◽  
pp. 301-308
Author(s):  
Bhasyani Nagaretnam ◽  
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Acute Abdomen ◽  
Free Fluid ◽  
Operation Theatre ◽  
Pregnancy Test ◽  
Obstetric Emergency ◽  
Child Bearing ◽  
Urine Pregnancy Test

Ectopic pregnancy is an obstetric emergency which accounts for 4% of all pregnancy-related deaths. All women of child bearing age with abdominal pain or vaginal bleeding presenting to the Emergency Department should be evaluated for ectopic pregnancy. However, there have been many reported cases of diagnostic challenges of ectopic pregnancy. One rare variant of ectopic pregnancy that can be easily overlooked is chronic ectopic pregnancy. We present this case of a 39-yearold female, who presented with acute abdomen and free fluid in her abdomen. Urine pregnancy test indicated she was not pregnant. However, intraoperative findings confirmed left tubular pregnancy. We would like to highlight three major diagnostic challenges we faced in this case i.e.; (i) women of child bearing age with abdominal pain should always be evaluated for ectopic pregnancy; (ii) diagnosis of ectopic pregnancy should not be dismissed even though the pregnancy test is negative; and (iii) the role of computed tomography (CT) scan in acute abdomen of unclear aetiology. As a rule, all haemodynamically unstable acute abdomen should be sent to the operation theatre. Haemodynamically stable patients should be carefully evaluated to facilitate surgical management.

scholarly journals Clinically Applicable Deep Learning for Intracranial Aneurysm Detection in Computed Tomography Angiography Images: A Comprehensive Multicohort Study

2020 ◽  
Author(s):  
Zhao Shi ◽  
Chongchang Miao ◽  
Chengwei Pan ◽  
Xue Chai ◽  
Xiu Li Li ◽  
...  
Keyword(s):  
Deep Learning ◽  
Intracranial Aneurysm ◽  
High Confidence ◽  
Common Life ◽  
Bone Removal ◽  
Life Threatening ◽  
Diagnosis Tool ◽  
Aneurysm Detection ◽  
A Prospective Study ◽  
Human Burden

AbstractIntracranial aneurysm is a common life-threatening disease. CTA is recommended as a standard diagnosis tool, while the interpretation is time-consuming and challenging. We presented a novel deep-learning-based framework trained on 1,177 DSA verified bone-removal CTA cases. The framework had excellent tolerance to the influence of occult cases of CTA-negative but DSA-positive aneurysms, image quality, and manufacturers. Simulated real-world studies were conducted in consecutive internal and external cohorts, achieving improved sensitivity and negative predictive value than radiologists. A specific cohort of suspected acute ischemic stroke was employed and found 96.8% predicted-negative cases can be trusted with high confidence, leading to reducing in human burden. A prospective study is warranted to determine whether the algorithm could improve patients’ care in comparison to radiologists’ assessment.

scholarly journals Clinical study of ectopic pregnancy

2020 ◽  
Vol 8 (2) ◽  
pp. 78-82
Author(s):  
sreelatha B ◽  
satyaprabha siripurapu ◽  
prasanna B
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Features ◽  
Dilatation And Curettage ◽  
Comprehensive Knowledge ◽  
Fertility Sparing ◽  
Incidence Risk ◽  
Life Threatening ◽  
Uncommon Condition ◽  
Tubal Surgery

Background: Ectopic pregnancy is not an uncommon condition and is potentially a life- threatening emergency. There is a rising trend in incidence which necessitates the gynecologists to have comprehensive knowledge about the disease. Aim of the study: To determine the incidence, risk factors, clinical features and management. Materials and method: This study is conducted in Department of Obstetrics and Gynecology of PIMS, Karimnagar. It is a retrospective descriptive study on patients who presented to our department with clinical features of ectopic pregnancy and later confirmed with intraoperative findings or ultrasound, in the 3-year period from January 2017 to January 2020. Result: A Total of 34 patients were diagnosed to have ectopic pregnancy with an incidence of 1in 114 deliveries. The cause of ectopic pregnancy was dilatation and curettage in 11.8% and PID, infertility, prior tubal surgery, previous abortions and OCP usage each contributes by 5.9%. Surgical treatment with salpingectomy was done in majority of the cases and medical management in 3 patients. Blood transfusions were given in 38.2% of cases. Postoperative period is uneventful in all the cases. Conclusion: Gynecologists should have comprehensive knowledge about the clinical presentation and risk factors of EP. If suspected clinically, encouraging women to undergo early ultrasonography allows early detection of EP and can be managed medically or fertility sparing surgical procedures

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