scholarly journals Study of diagnosis and management of ectopic pregnancy

2019 ◽  
Vol 8 (6) ◽  
pp. 2465
Author(s):  
Seema Patel ◽  
Ajesh Desai
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Lower Abdominal Pain ◽  
Age Group ◽  
Obstetrics And Gynaecology ◽  
Beta Hcg ◽  
Adnexal Pathology ◽  
A Prospective Study

Background: Diagnosis of ectopic pregnancy was frequently missed. Aim of the study was to determine the clinical presentation, and treatment associated with ectopic pregnancy.Methods: This is a prospective study which was carried out at Obstetrics and Gynaecology department, GMERS SOLA civil hospital from August 2017 to October 2018. Total 416 patients were admitted during study period out of them 50 patients diagnosed with ectopic pregnancy were enrolled in the study and information was collected and analysed.Results: 80% patients were between the age group of 21-30 years. 56% patients were nulliparous. Amenorrhea (92%) with lower abdominal pain (94%) is the most common presenting symptom. 26% of patients show typical triad of amenorrhea, abdominal pain and bleeding per vagina. UPT and USG were most commonly performed investigations. 96% cases showed UPT positive. 100% USG showed adnexal pathology. Serum beta-hCG was done in 37 patients as an aid for diagnosis and to decide the line of management. Conservative medical management with Injection MTX was done in 4 patients of which 1 patients required laparotomy later on. Surgical management was done in 90% of patients. Laparoscopic management was done in 54% of cases.Conclusions: Early diagnosis and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.

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 Effectiveness of Mifepristone in the Treatment of Uterine Leiomyomata

2013 ◽  
Vol 8 (1) ◽  
pp. 22-25
Author(s):  
Mayurika Sinha ◽  
A Kyal ◽  
P Mukhopadhay
Keyword(s):  
Side Effects ◽  
Uterine Leiomyoma ◽  
Endometrial Hyperplasia ◽  
Lower Abdominal Pain ◽  
Simple Type ◽  
Age Group ◽  
Uterine Leiomyomata ◽  
Obstetrics And Gynaecology ◽  
Perimenopausal Women ◽  
A Prospective Study

Aims: The goal of this study was to determine the effects of mifepristone in perimenopausal women with leiomyomas, thereby to see a decrease in severity of symptoms and a decrease in size of the leiomyomas. Methods: This was a prospective study conducted at Eden HospitalMedical College and Hospital, Kolkatafrom July 2010 to June 2011. Fifty patients received 20-25mg mifepristone daily and comparison was made between pre and post treatment symptoms and leiomyoma volume. Results: All patients became amenorrhoeic after treatment, relieving heavy menstrual flow most complained of. Lower abdominal pain improved by > 80% in most patients and volume of leiomyoma decreased appreciably. The drug did not have any major side effects. Endometrial hyperplasia detected by ultrasound in 42% patients was only of simple type on biopsy. Conclusions: Mifepristone can be useful in treating symptomatic women with uterine leiomyoma in perimenopausal age group, in those awaiting surgery to stop bleeding and improve anaemia and to reduce size of tumor to make surgery technically easier, making it a cheaper alternative to GnRH agonists and without any major side effects. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 22-25 DOI: http://dx.doi.org/10.3126/njog.v8i1.8856

scholarly journals Experience with Ectopic Pregnancy in a Tertiary Care Teaching Hospital

2018 ◽  
Vol 27 (2) ◽  
pp. 22-26
Author(s):  
NA Parveen ◽  
MM Sarker ◽  
MK Sarker
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Tertiary Care ◽  
Lower Abdominal Pain ◽  
Reproductive Age ◽  
Age Group ◽  
Treatment Morbidity ◽  
Incidence Risk ◽  
Abnormal Vaginal Bleeding

Ectopic pregnancy is a common life-threating condition. Diagnosis is frequently missed and should be considered in any women in the reproductive age group presenting with abdominal pain or vaginal bleeding. This prospective observational study was conducted in RMCH to determine the incidence, risk factors, clinical presentation, treatment, morbidity and mortality associated with ectopic pregnancy. A total of 50 cases of ectopic pregnancy were operated during the study period giving the incidence of ectopic pregnancy of 8.02/1000 pregnancies. The age of the patient ranged from 18-37 years, with maximum (40%) between 26-30 years age group. 36% patients had delivered one child and 24% were nulliparous. 30% patients had pelvic inflammatory disease and 22% had history of previous abortion/ MR. All patients presented with lower abdominal pain, 68% presented with abnormal vaginal bleeding and 60% had amenorrhoea. Most of the patients were diagnosed by high clinical suspicion and confirmed by USG. 96% cases ectopic pregnancy occurred in the fallopian tube and ampullary part was mainly affected. Laparotomy followed by unilateral salphingectomy was performed in majority (60%) of cases. 22% cases ipsilateral salpingectomy with tubectomy other side and 12% cases salpingostomy were performed. The recovery of majority of patients was smooth and uneventful. There was no death in this study.TAJ 2014; 27(2): 22-26

scholarly journals A prospective study of the lumps in the right hypochondrium

2020 ◽  
Vol 7 (3) ◽  
pp. 757
Author(s):  
Sudhir R. Jayakar ◽  
Prashant V. Male ◽  
Maitreyee M. Save ◽  
Varun S. Shetty
Keyword(s):  
Abdominal Pain ◽  
Prospective Observational Study ◽  
Clinical Presentation ◽  
Malignant Tumors ◽  
Abdominal Cavity ◽  
Age Group ◽  
Inclusion Criteria ◽  
Gall Bladder Carcinoma ◽  
The Right ◽  
A Prospective Study

Background: The abdominal cavity can harbour a varied spectrum of diseases. Abdominal lumps are one of the commonest disorders in this region. The clinical presentation, diagnosis, minimal investigations and optimum treatment of the lumps in the right hypochondrium were studied in detail in present study.Methods: The prospective observational study was carried out for 24 months. 60 consecutive patients who satisfied the inclusion criteria were taken up for the study. Calculation and analysis of data was done by using MS Excel.Results: The lumps in the right hypochondrium were most common in the 31-40 years age group in the present study. Majority of the lumps were found to be intraperitoneal (65%), of which 45% were neoplastic in nature. 68.3% as compared to 31.7% of lumps had an organ of origin which was not anatomically situated in the right hypochondrium viz. from right kidney and right adrenal. Hepatic lumps were found to be the commonest (35%), of which 14.3% were malignant tumors. Gall bladder carcinoma was more common in 40-60 years with female preponderance. Only 26.7% patients presented with the complaint of lump in abdomen. The commonest complaint was pain in the abdomen followed by vomiting. In 88.3% cases surgery was undertaken for curative or palliative purposes.Conclusions: Of all the lumps in the right hypochondrium, intraperitoneal lumps were more common with abdominal pain as commonest presenting symptom. The commonest lumps were found to be hepatic lumps. Incidence of Neoplastic masses was more than infections and infestations.

scholarly journals Clinical study of ectopic pregnancy

2017 ◽  
Vol 6 (8) ◽  
pp. 3498
Author(s):  
Meenakshi T. Chate ◽  
Bhagyashree Chate ◽  
Kranti Chate
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Public Health Issue ◽  
Common Symptom ◽  
Age Group ◽  
Common Site ◽  
Common Risk Factor ◽  
Medical College ◽  
Endometrial Cavity ◽  
Rising Incidence

Background: Ectopic pregnancy is pregnancy that develops following implantation anywhere other than the endometrial cavity of uterus. Objective of present study was to investigate the risk factors, clinical presentation and sites of ectopic pregnancy along with management and assessment of risk of maternal mortality and morbidity.Methods: The study was undertaken at Dr. Shankar Rao Chavhan Government Medical College and Guru Govind singhji hospital, Nanded between December 2012 and May 2014 after obtaining clearance from the Hospital Ethical Committee.Results: Maximum incidence of tubal gestation occurred between the age group of 21-25 years. Greater incidence was noted in multiparous woman. Tubectomy was the most common risk factor seen in 23.65% cases. The most common symptom observed is abdominal pain seen in 92.47% cases. The most common site of ectopic was ampulla seen in 51.61% cases. The most common mode of presentation was rupture seen in 71 cases about 76.35% cases. Unilateral salpingectomy was done in 70 cases about 75.26% cases.Conclusions: Since ectopic pregnancy remains a gynecological catastrophe in countries and a major challenge to the reproductive performance of women worldwide, it should be considered a relevant public health issue. With its rising incidence, which is likely to continue increasing because of the various factors discussed, it is necessary to devise means of early detection and treatment.

scholarly journals Study on Risk Factors, Clinical Presentation & Operative Management of Ectopic Pregnancy

2016 ◽  
Vol 28 (1) ◽  
pp. 9-14
Author(s):  
Kamrun Nahar ◽  
Turani Talukder ◽  
Sabiha Sultana ◽  
Md Anwar Hossain
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Operative Management ◽  
Age Group ◽  
Presenting Symptoms ◽  
Patient Profile ◽  
Short Period ◽  
History Of ◽  
Acute Condition

Introduction: Ectopic pregnancy is a major clinical problem in gynaecology because it is often difficult to diagnose as the patient present in different ways. An accurate history taking and physical examination is considered to be most important in the diagnosis of ectopic pregnancy. There are two treatment options, medical or surgical. Surgical treatment is the fastest treatment for ectopic pregnancy though surgical management decreased from approximately 90% to 65%1. Surgery may be the only treatment option if there is internal bleeding. In the medical treatment group, 15% of cases were categorized as failures and required surgery1.Objectives: This study was conducted in the department of obst and Gynae of Dhaka Medical College Hospital from January 2005 to June 2005 in an attempt to find out the risk factors of ectopic pregnancy, the way of presentation and to analyze the operative treatment of ectopic pregnancy.Materials and Methods: A total 50 consecutive patients who were clinically suspicious of ectopic pregnancy were included in this study between January 2005 to June 2005. Patients who were clinically suspicious of EP and also supported by positive urinary pregnancy tests, beta hCG and no intrauterine gestational sac in ultrasonography were included in this study. Detailed discussion about the study was done with the patient and then informed verbal consent was taken from them. Detailed history about patient profile, presenting symptoms, any risk factors and clinical examination done and the findings were recorded in the predesigned data collection sheet. Data was expressed in terms of frequencies and percentagesResults: Most of the patients were in the age group of 20-30 years and 38% of low parity (para- 1).Previous miscarriage, infertility,IUCD users and PID identified as the risk factors of ectopic pregnancy— 42% patients had history of previous abortion or MR, period of infertility 22%, pelvic infection 12%, IUCD users 16%. In this study acute abdominal pain after a short period of amenorrhoea was found to be the main symptoms in ectopic pregnancy—100% patients were presented with lower abdominal pain, 70% with period of amenorrhea and 50% patients with per vaginal bleeding. All the patients were presented with acute condition and were surgically managed fastest treatment. At the time of operation 84% of ectopic tubal pregnancy were found ruptured, 10% were tubal abortion and 4% unruptured. Sites of ectopic pregnancy were ampullary 50%, isthmic 20%, fimbrial 10%.Conclusion: Most of the patient presented in acute condition with the classical features of ruptured ectopic pregnancy. Near half of the patient were in younger age group (26 – 30 years) having risk factors like history of previous abortion/MR 42%, infertility 22% use of IUCD 16%, PID 12%. More then three forth( 84%) of cases were diagnosed as ruptured ectopic during operation. Operative management was done on the basis of site of ectopic and parity of the womanBangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 9-14

scholarly journals Clinical presentation and outcome of ectopic pregnancies in a tertiary care rural hospital

2019 ◽  
Vol 8 (2) ◽  
pp. 692
Author(s):  
Indu Verma ◽  
Punya Priya ◽  
Charvi Chugh ◽  
Harsharan Kaur ◽  
Dinesh Sood
Keyword(s):  
Ectopic Pregnancy ◽  
Rural Areas ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
First Trimester ◽  
Rural Hospital ◽  
Reproductive Age ◽  
Age Group ◽  
Pain Site ◽  
Tract Infections

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.

Ischaemic colitis diagnosed by sigmoidoscopy during pregnancy

2021 ◽  
Vol 14 (5) ◽  
pp. e239975
Author(s):  
Tsubasa Ito ◽  
Kazuki Takasaki ◽  
Minori Takada ◽  
Akira Tomioka
Keyword(s):  
Abdominal Pain ◽  
Conservative Treatment ◽  
Clinical Presentation ◽  
Lower Abdominal Pain ◽  
Good Recovery ◽  
Ischaemic Colitis ◽  
Endoscopic Findings ◽  
Pregnancy And Postpartum ◽  
Intravenous Hydration ◽  
Multidisciplinary Teamwork

A 21-year-old woman visited out hospital for lower abdominal pain and bloody diarrhoea at 19 weeks of pregnancy. Endoscopic findings revealed longitudinal ulcerations with hyperaemia and oedema in the sigmoid colon. These findings and clinical presentation confirmed the diagnosis of ischaemic colitis. Conservative treatment, including fasting and intravenous hydration, was administered, and the patient made a good recovery. After discharge, there was no recurrence during pregnancy and postpartum period. It is important to make early diagnosis and treatment, and multidisciplinary teamwork between obstetricians, gastroenterologist and endoscopist is required.

scholarly journals Heterotopic Pregnancy: A Clinical Case Report

1970 ◽  
Vol 39 (3) ◽  
Author(s):  
S Chowdhury ◽  
T Chowdhury
Keyword(s):  
Abdominal Pain ◽  
Case Report ◽  
Ectopic Pregnancy ◽  
Clinical Examination ◽  
Clinical Case ◽  
Lower Abdominal Pain ◽  
Tubal Pregnancy ◽  
Heterotopic Pregnancy ◽  
Intrauterine Pregnancy ◽  
Ectopic Pregnancies

Heterotopic pregnancy is coexistence of intrauterine and extrauterine pregnancies that is ectopic pregnancies. It is said to be rare. Here we report a case of 27 years old woman with heterotopic pregnancy. Patient had a typical presentation of severe lower abdominal pain following amenorrhoea for 2½ months. On clinical examination, there was suspicion of ectopic pregnancy but ultrasonography revealed early intrauterine pregnancy along with right tubal pregnancy with huge collection in abdomen . Immediate laparotomy was done and diagnosis was confirmed as a case of heterotopic pregnancy.DOI: http://dx.doi.org/10.3329/bmj.v39i3.9950 BMJ 2010; 39(3)

scholarly journals Spectrum of ectopic pregnancy in tertiary care centre

2018 ◽  
Vol 7 (4) ◽  
pp. 1435
Author(s):  
Ishrat Zuber ◽  
Vaishali Chaurasia
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Previous History ◽  
Stable State ◽  
Clinical Findings ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Presenting Symptoms

Background: Ectopic pregnancy is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergency in day-to-day practice. Objectives of present study were to know the incidence of Ectopic pregnancy at Tertiary care centre, the age group, parity and risk factor of ectopic pregnancy, the clinical presentation of ectopic pregnancy and the outcome and management of ectopic pregnancy.Methods: It was a retrospective study conducted at Chirayu Medical College and Hospital, Bhopal from 1st June 2009 to 31st May 2014. A total of 42 patients with ectopic pregnancy were analyzed on clinical presentation, clinical findings, investigations, operative findings and outcome.Results: A majority of women (64.29%) were in the age group of 21-30 years and 78.57% were multigravida. Commonest risk factors were previous history of abortion (23.80%) and pelvic inflammatory disease (14.28%) Amenorrhea (92.85%) and pain abdomen (89.22%) were the most common presenting symptoms. Ampulla of fallopian tube was the commonest site (45.23%). Unilateral salpingectomy was performed in 40.47% patients. There were no maternal deaths and majority (80.96%) were discharged within seven days.Conclusions: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. Early diagnosis and referral in hemodynamically stable state along with use of minimal access surgery or medical management can change the scenario of ectopic pregnancy in the developing world.

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