scholarly journals Broad ligament ectopic pregnancy: a dilemma to diagnose

2019 ◽  
Vol 8 (2) ◽  
pp. 751
Author(s):  
Namrata Saxena ◽  
Neeta Bansal ◽  
Pradeep Singhal ◽  
Monika Ramola
Keyword(s):  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Previous History ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Previous Surgery ◽  
Lower Segment ◽  
Laparoscopic Skills ◽  
Lower Segment Cesarean Section ◽  
History Of

Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis, but definitive diagnosis is made only during surgery. Authors are reporting a case of 30 years female G3P1L1A1 seven weeks pregnancy with previous lower segment cesarean section and previous history of right sided salpingectomy with no complaints. Ultrasound was advised to know the location of sac this time, in which, she was diagnosed as a case right sided unruptured live ovarian ectopic pregnancy. On examination, signs and symptoms of ectopic pregnancy were absent. On laparoscopy, she was diagnosed as a case of right sided live unruptured broad ligament ectopic pregnancy as her right ovary was absent because of previous surgery.  With advances in sonography and laparoscopic skills, more cases can be diagnosed in the first trimester and can be safely managed laparoscopically. 

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

scholarly journals Different Sonographic Faces of Ectopic Pregnancy

2017 ◽  
Vol 7 ◽  
pp. 6 ◽  
Author(s):  
Charu Chanana ◽  
Nishant Gupta ◽  
Itisha Bansal ◽  
Kusum Hooda ◽  
Pranav Sharma ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Vaginal Bleeding ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Pictorial Essay ◽  
History Of ◽  
Clinical Signs And Symptoms

Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

Progestogens for treatment and prevention of pregnancy disorders

2010 ◽  
Vol 3 (3) ◽  
Author(s):  
Adolf E. Schindler
Keyword(s):  
Premature Birth ◽  
Previous History ◽  
First Trimester ◽  
Study Groups ◽  
Treatment And Prevention ◽  
Maternal Immune System ◽  
Hydroxyprogesterone Caproate ◽  
History Of ◽  
Threatened Abortion ◽  
In Pregnancy

AbstractProgesterone appears to be the dominant hormone not only establishing a proper secretory endometrial development but also adequate decidualization to establish pregnancy and sustain pregnancy development. Progesterone is the natural immunoregulator to control the maternal immune system and not to reject the allogeneic fetus. There are two sources of progesterone: corpus luteum first and placenta later. Three progestogens can be used in pregnancy: (i) progesterone (per os, intravaginal and intramuscular), (ii) dydrogesterone (per os), and (iii) 17α-hydroxyprogesterone caproate (intramuscular). There are three indications, for which these progestogens can be clinically used either for treatment or prevention: (i) first trimester threatened and recurrent (habitual) abortion, (ii) premature labor/premature birth, and (iii) pre-eclampsia (hypertension in pregnancy). The available data are limited and only partially randomized. In threatened abortion the use of progesterone, dydrogesterone and 17α-hydroxyprogesterone caproate leads to a significant improved outcome, when at the time of threatened abortion a viable fetus has been ascertained by ultrasound. For prevention of recurrent abortion there are also some data indicating a significant effect compared with women without progestogen treatment. Prevention of preterm birth by progestogens (progesterone vaginally, orally and 17α-hydroxyprogesterone caproate intramuscularly) was significantly effective. The main study groups include pregnant women with a previous history of premature birth. However, also in women with shortened cervix use of progesterone seems to be helpful. The studies done so far in women with risk factors for pre-eclampsia or established pre-eclampsia were based on parenteral progesterone application. However, new studies are urgently needed.

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.

Previous induced abortion and ante-natal depression in primiparae: preliminary report of a survey of mental health in pregnancy

1978 ◽  
Vol 8 (4) ◽  
pp. 711-715 ◽  
Author(s):  
R. Kumar ◽  
Kay Robson
Keyword(s):  
Mental Health ◽  
Preliminary Report ◽  
Previous History ◽  
First Trimester ◽  
Induced Abortion ◽  
Depression And Anxiety ◽  
History Of ◽  
Expectant Mothers ◽  
Clinically Significant ◽  
In Pregnancy

SynopsisOne hundred and nineteen primiparae, who were routinely attending ante-natal clinics, were interviewed repeatedly between the 12th and 36th weeks of their pregnancies. The incidence of depression was highest in the first trimester and, overall, about a fifth of the sample was found to be suffering from clinically significant neurotic disturbances. In a proportion of these expectant mothers there was an association between depression and anxiety early in pregnancy and a previous history of induced abortion; this phenomenon may reflect a reactivation of mourning which was previously suppressed.

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 Case Report Postoperative Case of Explore Laparotomy for Ruptured Ectopic Pregnancy with Septicemia

2021 ◽  
pp. 270-274
Author(s):  
Minakshi Choudhary ◽  
Akhtaribano Sayyad ◽  
Seema Yelne ◽  
Sagar Bhovare ◽  
Deepesh Choudhary ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Pain Treatment ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Clinical Findings ◽  
Therapeutic Interventions ◽  
Excessive Bleeding ◽  
Operative Case ◽  
Diagnostic Ultrasonography

Introduction: Ectopic pregnancy is a pregnancy problem when the embryo attaches itself outside the uterus. Signs and symptoms include abdominal pain and vaginal bleeding, but less than 50 percent of affected women have both. it happened. Excessive bleeding may lead to a rapid heartbeat, fainting, or panic attack. Without abnormalities, the fetus can no longer survive. Obstetricians and gynaecologists face various obstacles in dealing with Jehovah's Witnesses. Main Symptoms and/or Important Clinical Findings: A 20-year-old man with a post-operative case of Explore Laparotomy For Ruptured Ectopic Pregnancy with pyosalpinx with septicemia underwent surgery on 14/02/2021 investigating Laparotomy under GA. His diagnostic ultrasonography was performed. Complete the blood test. She had not dropped down before 8 days she was a primigravida at 2 months of pregnancy and then had abdominal pain as she grew stronger over time. The Main Diagnoses, Therapeutic Interventions, and Outcomes: A 20-year-old man with a post-operative case of Explore Laparotomy for Ruptured Ectopic Pregnancy with pyosalpinx withsepticemia, with a complaint of abdominal pain, Treatment began on the day he received V fluids, Antibiotics Injectable. Initiated, Zonac suppository PR consulted. TPR Charting treatment interventions, I / O Charting, abortion chart, Nursing Perspectives: Laboratory techniques are urgently required. To limit the development of treatments to enhance the outcome. Conclusion: Although it is not uncommon for an ectopic pregnancy to exceed the first trimester, it does occur occasionally. As a result, in any emergency, abdominal surgery during pregnancy, Today, early intervention saves lives and reduces morbidity, but ectopic pregnancy still kills 4 to 10% of pregnant women and results in a higher ectopic pregnancy rate following pregnancy.

scholarly journals DETECTION OF HYPOTHYROIDISM IN EARLY PREGNANCY: UNIVERSAL SCREENING

2020 ◽  
pp. 1-4
Author(s):  
Manpreet Kour ◽  
Taranjeet Kour
Keyword(s):  
Pregnant Women ◽  
Previous History ◽  
First Trimester ◽  
Normal Serum ◽  
Systemic Review ◽  
Overt Hypothyroidism ◽  
Endocrine Disorders ◽  
History Of ◽  
Adverse Pregnancy ◽  
Hypothyroid Patients

Background: Thyroid dysfunction is one of the most common endocrine disorders in women of childbearing (1), second only to diabetes mellitus.The aim of this systemic review was to determine whether an increased maternal TSH level and normal serum T4 levels, as seen in SCH, could also be associated with pregnancy complications. Methods: This study was conducted in Nobel hospital,Pune January 2015 to July 2016 in all the pregnant women attending antenatal clinic in their first trimester of pregnancy. Data was collected on a pre-designed, pre-tested study proforma which includes socio-demographic information of patients, detailed clinical history and examinations of pregnant women and babies. Blood samples were taken under all aseptic precautions and were sent to laboratory of the institute for routine investigations and thyroid profile. Patients were followed up till delivery and babies were followed up till discharge from the hospital. Results:This study was conducted in 220 patients in obstetrics and gynaecology department in Noble Hospital, Pune. Out of 220 cases,198 cases were euthyroid, 13 cases were subclinical hypothyroid and 9 cases were overt hypothyroid. Hypothyroidism was found in 22(10%) of pregnant women in their first trimester. Out of which, 13(5.91%) had subclinical hypothyroidism and 9(4.09%) had overt hypothyroidism. Majority of the patients 45.45% were in age group of 26-30years. 90.91% of hypothyroid patients had regular cycles and 9.09% had irregular cycles. Hypothyroidism was equally distributed between primi and multigravida patients. 31.82% of hypothyroid patients had previous history of abortions and 68.18% had no such history.18.18% of hypothyroid patients had history of infertility and 31.82% had no history of infertility. Anti-TPO was present in 9.09% and none of euthyroid patients. Maternal and Fetal complications were found more in hypothyroid patients than euthyroid patients. Conclusion: Most of the patients in our study who have subclinical thyroid disease are asymptomatic, so screening is the most convenient method to identify such patients. Follow-up of abnormal TSH values with FT3 and FT4 may yield valuable results which could enable us for therapeutic intervention and may go a long way in preventing adverse pregnancy outcomes.

scholarly journals PRETERM LABOUR:

2017 ◽  
Vol 24 (09) ◽  
pp. 1376-1379
Author(s):  
Tasneem Azher ◽  
Iram Aslam ◽  
Saadia Bano ◽  
Uzma Shahzad
Keyword(s):  
Bacterial Vaginosis ◽  
Preterm Labour ◽  
Previous History ◽  
Health Care Facilities ◽  
University Hospital ◽  
Intrauterine Death ◽  
Inclusion Criteria ◽  
Lower Segment Cesarean Section ◽  
History Of ◽  
Independent University

Objectives: (1) to find out of aetiological factors of preterm labour. (2) To makea proposed remedy for prevention of preterm lobour. Material and Methods: This study wascarried out at Independent University Hospital. This is located at richly populated area ofFaisalabad, providing health care facilities to poor socioeconomic group. The patient who fitinto inclusion criteria was included in study and a well designed Proforma was used to collectthe sample. Duration of study: One year study from 1 May, 2014 to 30 April, 2015. Studydesign: It is a descriptive study. Sampling technique: A purposive random sample techniquewas used to collect the sample. Sample size: A total of 80 cases ware collected who wereadmitted through antenatal outdoor and emergency of IUH. Inclusion Criteria: All patients withdiagnosed preterm labour who had attended outdoor or emergency of Independent UniversityHospital were included in study. Exclusion Criteria: (1) Patients with Iatrogenic preterminduction of labour due to maternal factors like patients on chemo therapy or any debilitatingillness causing threat to maternal life. (2) Patients with congenitally abnormal foetus & intrauterine death of fetus. Results: A total of 80 cases with preterm labour were included in studyat Independent University Hospital. In current study 30 (37.5%) patients had age between 18 –25 years, 30 (37.5%) patients had age between 26-35 years and rest of the 20 (25%) patientshad age > 35 years. Among 80 patients 25 (31.3%) patients had parity b/w 1-3 while 28 (35%)patients had parity b/w 4-5 and rest of the 27 (33.8%) had parity > 5. More patients i.e 50(62.5%) patients were admitted through emergency while 30 (37.5%) patients were admittedthrough Out Patient Department (OPD). 37 (46.3%) patients had Spontaneous vaginal deliveryand 43 (53.8%) patients underwent lower segment cesarean section. In our study, the mostcommon risk factor associated with preterm labour was bacterial vaginosis 20 (25%) patientshad bacterial vaginosis. 10 (12.5%) patients had chorioamniotis. Previous history of pretermbirth was present in 10 (12.5%) patients. History of Preterm Premature ruptures of membranesin 8 (10%) patients. 11(13.5%) patients has history of previous C-section and impending scardehiscence. History of anti partum hemorrhage and pregnancy induce in hypertension waspresent in 5 (6.5%) patients. FGR with oligohydramnios was present in 6 (7.5%) patients. 3((3.75%) patients presented with preterm breech

scholarly journals A study of feto-maternal outcome in bleeding per vaginum in first trimester of pregnancy

2020 ◽  
Vol 9 (3) ◽  
pp. 1191
Author(s):  
Jaydeep J. Bhatu ◽  
Darshil S. Prajapati
Keyword(s):  
Vaginal Bleeding ◽  
Local Population ◽  
Previous History ◽  
Perinatal Outcomes ◽  
First Trimester ◽  
Maternal Complications ◽  
History Of ◽  
Threatened Abortion ◽  
Degree Of Association ◽  
In Pregnancy

Background: Bleeding per vaginum in the first trimester is a common obstetric entity. Four major causes of pathological bleeding in 1st trimester are miscarriage, ectopic pregnancy, implantation bleeding of pregnancy and cervical pathology. The purpose of this study was to investigate and understand the effect of first trimester vaginal bleeding on maternal and perinatal outcomes in the local population to which our hospital serves. Objective of this study was to estimate the degree of association between first-trimester bleeding and miscarriage, pregnancy outcomes in women with threatened abortion, various maternal complications and outcome of labor in pregnancy complicated by first-trimester bleeding and adverse fetal outcomes affected with first trimester bleeding.Methods: This prospective observational study was carried out on 110 women attending hospital with history of first trimester vaginal bleeding at a tertiary health center - sola civil hospital Ahmedabad for a period of twelve months.Results: Majority (69%) of first trimester bleeding occurs in age group of 21-30 years and majority of patients were primigravida constituting 53% out of 110 patients, 48 patients presented with abortions, out of which 26 had threatened abortion and 22 had other abortions. Primi para with previous history of bleeding per vaginum had more chances to go in full term in present pregnancy.Conclusions: Patients presenting with heavy bleeding per vaginum ended up in pregnancy loss and thus a poor outcome. In the presence of sub-chorionic hematoma, the prognosis of pregnancy is greatly affected as the risk of pre-term, IUGR and especially miscarriages increase significantly.

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