scholarly journals A retrospective study of ectopic pregnancy at a tertiary care centre

2017 ◽  
Vol 6 (12) ◽  
pp. 5241 ◽  
Author(s):  
Archana Mehta ◽  
Shehla Jamal ◽  
Neerja Goel ◽  
Mayuri Ahuja
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Tubal Pregnancy ◽  
Tertiary Care Centre ◽  
Future Fertility ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.

scholarly journals A comparative study of ectopic pregnancy at a tertiary care centre

2018 ◽  
Vol 7 (2) ◽  
pp. 694
Author(s):  
Radhika Pusuloori ◽  
K. Dilzith Arora
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Conservative Surgery ◽  
Tubal Pregnancy ◽  
Tertiary Care Centre ◽  
Future Fertility ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the Department of Obstetrics and Gynecology at Chalmeda Anandarao Institute of Medical Sciences, Karimnagar, Telangana from February 2014 to January 2017. A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.

scholarly journals Study of ectopic pregnancy in a tertiary care centre

2019 ◽  
Vol 9 (1) ◽  
pp. 212
Author(s):  
Nitesh Meena ◽  
Radheshyam Bairwa ◽  
Savitri Sharma
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Tertiary Care Centre ◽  
Presenting Symptoms ◽  
Mortality Incidence ◽  
Ectopic Pregnancies ◽  
The Right

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in department of obstetrics and gynaecology, jhalawar medical college, Jhalawar, Rajasthan, India from January 2019 to October 2019. All patients admitted with diagnosis of ectopic pregnancy, either ruptured or unruptured where included in the study.Results: Total 52 patient of ectopic pregnancy were studies. Majority (63.46%) of patients belong to the age group 21-30 years. Ectopic pregnancy was most commonly noted in nulliparous woman (44.23%) Majority of the case (31%) had no risk factors among remaining (34.61%), previous MTP (17%), (17-30%) previous ectopic (9%) and PID (15-38%) were identified risk factors. Ampulla (75%) was the most common site for ectopic pregnancy. 57% of the cases were on the right side. The common presenting complaints were pain in abdomen (81%) bleeding/ spotting per vaginal (42%). There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital screening of high-risk case, early diagnosis and early intervention reduce the morbidity and mortality in ectopic pregnancies.

scholarly journals A clinical study of ectopic pregnancy in a tertiary care centre in Central India

2017 ◽  
Vol 6 (6) ◽  
pp. 2485
Author(s):  
Mridula Shrivastava ◽  
Hemlata Parashar ◽  
Jyoti Nath Modi
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Central India ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Tertiary Care Centre ◽  
Presenting Symptoms ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. The incidence of ectopic pregnancy is on a rise globally. Risk factors and causes for ectopic pregnancy may vary with the setting and geographically.Methods: A retrospective analysis of all operated ectopic pregnancies over a 5-year period; between June 2011 to May 2016, was done. Surgically confirmed cases were included in this study and a detailed analysis of presenting symptoms, age, parity and high risk factors was carried out.Results: A total of 50 patients were operated for ectopic pregnancy at our hospital during the study period. Analysis was done for 47 of these due to incomplete data for 3 patients. Majority (62%) of patients belonged to the age group 20-29 years and were gravida 3 and above. Ninety two percent were ruptured ectopic. Sixty two percent ectopic pregnancies were on right side. The common presenting complaints were pain in abdomen (81%) and bleeding/spotting per vaginum (43%). The mean duration between onset of symptoms and reporting to hospital was one and a half day and the average time between admission to hospital and surgery was 9 hours. The ectopic pregnancies were managed surgically in all cases. No obvious risk factors were identified in 34% patients. Among the remaining, previous MTP (17%), previous ectopic (9%) and PID (7%) were identified risk factors. There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital. Screening of high risk cases, early diagnosis and early intervention reduces the morbidity and mortality in ectopic pregnancies.

scholarly journals Clinical study on presentation and management of ectopic pregnancies in a tertiary care centre

2019 ◽  
Vol 9 (1) ◽  
pp. 173
Author(s):  
Anjum Ara ◽  
Indu Chawla ◽  
Rasika Agarwal ◽  
Bangali Manjhi
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Treatment Modality ◽  
Adnexal Mass ◽  
Care Center ◽  
Tertiary Care ◽  
Uterine Cavity ◽  
Free Fluid ◽  
Tertiary Care Centre ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy means pregnancy outside the normal uterine cavity. It is the leading cause of maternal morbidity and mortality in first trimester. Early diagnosis and timely intervention can significantly improve the outcomes.Methods: Retrospective observational study done in the department of obstetrics and gynecology ABVIMS and Dr. RML hospital, New Delhi from January 2016 to March 2019. Case records of 76 patients of confirmed ectopic pregnancy were retrieved and studied from the medical record section. The main aims were to see the clinical presentation, mode of diagnosis, predisposing risk factors; treatments offered and associated morbidity and mortality.Results: The incidence of ectopic pregnancy in present study was 1.7%, highest in 21 to 30 years age multiparous patients. 85.1% presented as acute emergencies, 75% patients had classic triad of amenorrhea, pain and bleeding. Pain was the commonest symptom in 96.1%. The commonest clinical sign was adnexal mass and tenderness. Ultrasound findings had adnexal mass in 98.7% and free fluid in 84.7% cases with empty uterus in 100%. 90.7 % case were tubal ectopic and 69.73 % were ruptured. Surgery was the main treatment modality in 96.0% cases. Salpingectomy was the commonest surgery in 80.25%. There was 0% mortality and 78.9% cases required blood transfusions, 44.7% patients had no known risk factors whereas some of the common identifiable risk factors were history of previous abortion, previous pelvic surgeries and pelvic inflammatory disease.Conclusions: ABVIMS and Dr. RML hospital is a tertiary care center so majority of patients with ectopic pregnancies presented late, as such surgery was the main treatment modality but there was 0% mortality in our study. Conservative treatments such as laparoscopy and medical management can also be offered to hemodynamically stable patients.

scholarly journals A clinical study of ectopic pregnancy at a tertiary care centre in Telangana, India

2020 ◽  
Vol 9 (2) ◽  
pp. 682
Author(s):  
Subha Ranjan Samantaray ◽  
Ipsita Mohapatra ◽  
Achanta Vivekanada
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
High Morbidity ◽  
Tertiary Care Centre ◽  
Life Threatening ◽  
History Of

Background: Ectopic pregnancy (EP) is a life-threatening obstetrics emergency in early trimester, associated with a high morbidity and mortality if not timely intervened.  High index of clinical suspicion is required for early diagnosis, specifically in women presenting with amenorrhoea, pain abdomen and vaginal bleeding. Aim of this study is to determine the incidence, risk factors, clinical presentation, management and outcome of ectopic pregnancy.Methods: This retrospective observational study was conducted in the department of obstetrics and gynaecology, at Prathima institute of medical sciences, Telangana from July 2012 to June 2019, for a period of 7 years. A total of 53 cases of ectopic pregnancy were analyzed for parameters like age, gravidity, gestational age, risk factors, clinical presentation, management and morbidity.Results: Incidence of ectopic pregnancy was 5.3 per thousand deliveries. Majority of cases were in age group of 20 to 25 years (52.8%) and were gravida 3 and above (68%). The commonest risk factors identified were history of previous pelvic surgeries (37.7%) followed by history of abortion (18.8%). Commonest symptoms were abdominal pain (90.6%), amenorrhoea (75.5%) and vaginal bleeding (47.2%). Only 41.5 % of cases had triad of symptoms. Fallopian tube (92.4%), specifically ampulla (62.3%) was the most frequent site affected. About 73.6% cases presented with ruptured tube. Surgery (94.3%) was the mainstay of therapy.Conclusions: ectopic pregnancy is a life-threatening emergency, early diagnosis and treatment will improve the prognosis.

scholarly journals Prospective study on ectopic pregnancy in a tertiary care hospital

2021 ◽  
Vol 10 (5) ◽  
pp. 1889
Author(s):  
M. Ilanjselvi ◽  
K. Shobana Priya
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
High Risk Factors ◽  
Ectopic Pregnancies ◽  
Laparoscopic Salpingectomy

Background: Pregnancy of unknown location was frequently missed and increasing incidence of ectopic pregnancy needs awareness about common risk factors, mortality and morbidity. Aim of this study is identify the incidence, clinical presentation, risk factors, treatment, mortality and morbidity associated with ectopic pregnancies.Methods: Prospective analysis of ectopic was done in Chengalpattu Government Medical College and Hospital from December 2018 to December 2019. Parameters included in this study was age, parity, gestational age, risk factors, clinical presentation, site of ectopic, need of blood transfusion, mode of management, mortality and morbidity were identified.Results: Out of 10900 deliveries, 53 were ectopic pregnancies (0.48%). Women with age 20-25 years had highest incidence (54.71%) and with least below 20yrs and above 40 years (1.88%). Ectopic pregnancies were common in multiparous women (70.68%) than primigravida (28.30%). Common symptoms: amennorhea (98.11%), pain abdomen (96.22%), bleeding per vaginum (47.16%) patients. Urine pregnancy test positive in 98.11%. Etiology was pelvic infection (18.88%), surgeries including LSCS and tubal surgeries (15.09%), previous dilatation and curettage was done in (15.09%) cases, previous ectopic (5.66%), intrauterine contraception usage seen in (1.88%). Right sided ectopic was more common. Site of ectopic: common in fallopian tube- ampullary region (54.71%)), fimbria (22.64%), isthumus (11.32%), followed by ovarian ectopic (5.66%) cornual (3.77%), caesarean scar (1.88%) tubal abortion (1.88%). About 94.33% of ectopic was ruptured, 3/4th of these patients presented with shock at the time of presentation. Most of cases being ruptured ectopic pregnancies, unilateral salpingectomy in 75.47% and unilateral salpingoopherectomy in 3.77%. Salpingectomy with contralateral tubal ligation done in 15.09%, laparoscopic salpingectomy done in 3.77%, hysterectomy done for 1.88%. Blood transfusion was done in (96.22%), without single mortality.Conclusions: Immediate prompt diagnosis, identifying the high-risk factors and early intervention by conservative or surgical management will help in reducing the mortality and morbidity associated with ectopic pregnancted.

scholarly journals Clinicosociodemographic profile of ruptured ectopic pregnancies at a tertiary care centre

2017 ◽  
Vol 6 (5) ◽  
pp. 1885
Author(s):  
Soumya Ranjan Panda ◽  
Anjali Rani ◽  
Mahendra Meena
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Factors Associated ◽  
Number Of Patients ◽  
History Of ◽  
Ectopic Pregnancies

Background: Rupture of an ectopic pregnancy remains the most dreaded complication of a pregnancy related event and is the commonest cause of maternal mortality in the first trimester of pregnancy. In the developing countries, the maternal death rate among patients admitted with ectopic pregnancy was found to be as high as one in ten. In addition to high risk for mortality, rupture of an ectopic pregnancy could affect future fertility of a woman. The objectives of this study are to analyse the sociodemographic and clinical characteristics and find out the incidence rate and risk factors associated with ruptured ectopic pregnancies in a tertiary care institution.Methods: This is a retrospective study and was conducted over a period of one year from September 2015 to September 2016 in Department of Obstetrics and Gynecology at Institute of Medical Sciences, BHU, Varanasi, India. It is a tertiary care centre getting referrals not only from nearby cities and hospitals but also from major cities of neighbour states. During this time frame a total of 2601 deliveries have taken place and 57 cases of ruptured ectopic pregnancies were reported. Data were collected in a preconceived format.Results: Total numbers of vaginal deliveries were 2601 during the study period. Out of which 63 (2.42%) were found to be ectopic pregnancies and 57 (1.99%) were diagnosed as ruptured ectopic pregnancies. Maximum number of patients (70.17%) were between 21 and 30 years of age. As far as parity is concerned only 12.29 % of patients were primigravida where as 70.71% patients were multigravida. Previous history of pelvic inflammatory disease was associated among maximum number of cases i.e 50.87% of total number of cases. Among other risk factors, previous abortions, previous ectopic pregnancies and history of infertility treatment were the prime ones. Maximum number of patients were from lower and lower middle class socioeconomic status. Ampullary type of Tubal ectopic pregnancies were found to be the commonest ones. Two cornual pregnancies and two ovarian pregnancies were also found in this series. In 85.97 % of patients the amount of hemoperitoneum was found to be more than 500 ml.Conclusions: There is high incidence rate of ectopic pregnancy and low rate of diagnosis before rupture occurs in developing nations as in our scenario. Pelvic inflammatory disease, Maternal education, socioeconomic status, parity and history of subfertilty are the risk factors associated with ruptured ectopic pregnancy. Effective efforts should be taken to encourage the level of education and improve the rate of diagnosis among health care providers before the occurrence of rupture.

scholarly journals A clinical study of ectopic pregnancy in a tertiary care centre in Hubli

2017 ◽  
Vol 6 (4) ◽  
pp. 1566
Author(s):  
Swetha Dama ◽  
Amitha Kamat
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Tubal Sterilization ◽  
Tertiary Care Centre ◽  
History Of ◽  
Ectopic Pregnancies ◽  
One Year ◽  
High Degree

Background: To evaluate the burden of ectopic pregnancies in our hospital over the period of one year and to evaluate the risk factors, mode of intervention and outcomes of those cases.Methods: A retrospective analysis was conducted in Karnataka Institute of Medical Sciences, Hubli over the period of one year from January 2015 to December 2015. All patients admitted with a diagnosis of ectopic pregnancy, either ruptured or unruptured were included in the study. Their history, risk factors, outcome and complications were also evaluated in detail.Results: 40 patients with diagnosis of ectopic pregnancy were admitted, yielding to an incidence of 3.76/1000. Most patients presented to our hospital in a state of shock. 26(65%) were ruptured, 10(25%) were unruptured and 4(10%) were chronic ectopic pregnancies. 39 cases were managed by laparotomy and one patient by conservative method using methotrexate. Most common risk factor noted in our study was history of tubal sterilization, noted among 12(30%) women. No mortality was noted in our study.Conclusions: Ectopic pregnancy is a significant cause of morbidity and mortality in first trimester. High degree of suspicion and early detection can prevent a great degree of morbidity among women, especially in women with prior tubal sterilization procedure.

A Clinicopathological Review of Adnexal Masses in a Tertiary Care Centre of Rural Haryana - A Retrospective Study

2021 ◽  
Vol 8 (30) ◽  
pp. 2719-2723
Author(s):  
Shivani Khandelwal ◽  
Lakra Pinkey ◽  
Sangwan Vijayata ◽  
Mahendru Rajiv ◽  
Siwach Sunita ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Tertiary Care ◽  
Serous Cystadenoma ◽  
Common Symptom ◽  
Tertiary Care Centre ◽  
Adnexal Masses ◽  
Sexually Transmitted ◽  
Medical College ◽  
Wide Range ◽  
Ectopic Pregnancies

BACKGROUND There is a wide range of adnexal masses ranging from functional cyst to infection and even malignancy. Epithelial ovarian tumours are the most common benign ovarian lesion. The purpose of this study was to study the pattern of adnexal masses in rural area and plan the preventive steps according to the pattern. METHODS It was a retrospective study of patients who presented with adnexal masses in Bhagat Phool Singh Medical College (Women), Khanpur, Sonepat, Haryana, India over a period of 5.5 years from September 2012 to August 2018. The file records of the patients who underwent surgery for adnexal masse were evaluated to identify the risk factors, presenting complaints, examination findings, serological markers and radiological findings. The histopathological reports were reviewed. The cases excluded were ectopic pregnancies. Frequency distribution tables were used and data was analyzed using percentages. RESULTS Out of total 180 adnexal masses, 167 (92.77 %) cases were of ovarian origin. Out of these, 150 (83.33 %) cases were benign and 17 (9.44 %) were malignant. Among the benign lesions, serous cystadenoma was the most common lesion counting for 54 cases i.e., 30 %. In our study, most common symptom was vague abdominal pain- 63.88 %. Maximum adnexal masses were in the age group of 41 - 50 years i.e., 53 (29.44 %). Different types of surgeries were done. Maximum were bilateral oophorectomies with transabdominal hysterctomy 88 (48.88 %). CONCLUSIONS By proper education about personal and perineal hygiene, use of contraceptives, we can at least prevent some sexually transmitted diseases causing pelvic inflammatory disease (PID) and adnexal masses. KEYWORDS Adnexal Mass, Benign, Malignant, Serous Cystadenoma

scholarly journals A clinical study of trends of ectopic pregnancy and its management in a tertiary care hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4834
Author(s):  
Chandana M. Puttaraju ◽  
Nagothi Nagendra Prasad ◽  
M. P. A. Sailakshmi
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Sex Education ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Diagnostic Tools ◽  
Care Hospital ◽  
Care Teaching ◽  
Β Hcg ◽  
Ectopic Pregnancies

Background: Ectopic gestation is a gynaecological emergency which culminates in pregnancy loss and causes significant maternal morbidity, mortality besides jeopardizing future conception. The study discusses the incidence, risk factors, symptomatology and management of ectopic pregnancy in a tertiary care teaching hospital.Methods: This was a prospective study of 45 cases of ectopic pregnancies at a tertiary care teaching hospital from January 2012 to December 2013. Information was collected in a structured proforma, tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 1.17%. Majority of the patients (80%) belonged to 20-30 yrs age group. Second gravidas predominated (42.2%). Fallopian tube was the most common site (95.5%). Rudimentary horn ectopic accounted for 4.65%. Previous abdominopelvic surgery (31.1%), IUCD usage (22.2%), PID (20%), abortions (20%), tubectomy (15.5%) were the principal risk factors. 42% of the patients had no risk factor. The triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 51.1% of cases. Ultrasound, UPT, β-hCG estimation were the diagnostic tools. Ruptured ectopic pregnancy accounted for 64.4%. Nearly 95.5% of patients underwent surgery; salpingectomy (76%). Methotrexate was successful in 4.44%. There was no maternal mortality.Conclusions: Mostly diagnosis, prompt surgical or medical management is cornerstone of treatment. Primary prevention such as improved access to family planning services, sex education, treatment of STI, PID, surgical asepsis  and haemostasis, implementing legislation for dispensing MTP drugs ameliorate risk factors and hence reduce ectopic pregnancy.

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