Study of demography and clinical profile of ectopic pregnancies in a tertiary level hospital in Uttarakhand: a five year review

Background: Ectopic pregnancy is a condition when a fertilized ovum is implanted outside the uterine cavity. Life threatening risk of rupture of ectopic pregnancy remains one of the important causes of maternal mortality in India. The aim of study is to analyse the clinical profile, associated risk factors, complications, treatment outcomes to improve maternal mortality and morbidity associated with ectopic pregnancy.Methods: It is a retrospective study conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences from January 2015 to January 2020. A total of 182 patients diagnosed of Ectopic Pregnancy were analysed for clinical profile, risk factors, serology, ultrasound findings, complications, treatment offered and outcome.Results: During the study period of 5 years there were total 182 patients who were diagnosed of ectopic pregnancy showing the incidence of ectopic pregnancy in our hospital 1.4% of total number of deliveries. Majority of patients were in the age group of 25 to 30 years (43.95%). Mostly multiparous women (80.1%) had ectopic pregnancy. Majority of patients (56.1%) had no associated risk factors for ectopic pregnancy. Main presenting complain was abdominal pain in 58.8% of patients. Majority of patients (63.2%) had surgery as primary care which indicates delay in diagnosis and arrival at hospital especially in hilly region of Uttarakhand.Conclusions: Ectopic pregnancies need to be diagnosed timely to decrease maternal morbidities and mortalities. Clinical signs and symptoms with serology (Serum beta hCG) and radiological findings helps to optimize treatment for potentially life-threatening condition.

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Heterotopic pregnancy; case report

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v7i05.425 ◽

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.

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Retroperitoneal Ectopic Pregnancy: Diagnosis and Therapeutic Challenges

Case Reports in Surgery ◽

10.1155/2017/9871865 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Salma Ouassour ◽

Abdelhai Adib Filali ◽

Mohamed Raiss ◽

Rachid Bezad ◽

Zakia Tazi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Case Report ◽

Ectopic Pregnancy ◽

Management Strategy ◽

Clinical Signs ◽

Imaging Features ◽

Resonance Imaging ◽

Life Threatening ◽

History Of ◽

Ectopic Pregnancies

Background. Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report. We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space. Conclusion. Retroperitoneal ectopic pregnancy is an uncommon entity with rather complex pathogenesis. Clinicians should carefully interpret clinical signs, biological findings, and imaging features and be aware of unusual locations such as the retroperitoneum for ectopic pregnancies. Early diagnosis and appropriate management strategy are conditio sine qua non for successful treatment outcomes.

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Twelve Week Ruptured Interstitial Ectopic Pregnancy

Şehir Tıp Dergisi ◽

10.37609/cmj.1429 ◽

2020 ◽

Vol 1 (1) ◽

pp. 23-26

Author(s):

Sadık Kükrer ◽

Ayfer Pepekal Kukrer ◽

Eren Haytoğlu ◽

Erdal Yılmaz

Keyword(s):

Maternal Mortality ◽

Ectopic Pregnancy ◽

Reproductive Age ◽

Tubal Ectopic Pregnancy ◽

Mortality And Morbidity ◽

Life Threatening ◽

Gestational Sac ◽

Interstitial Ectopic Pregnancy ◽

Ectopic Pregnancies ◽

Related Mortality

Despite advancements in management and diagnosis, ruptured ectopic pregnancy is still a major reason for pregnancy-related mortality and morbidity. 2% of all pregnancies are ectopic pregnancy and interstitial ectopic pregnancy rate is 2-4% among all ectopic pregnancies. We should consider about it as an essential characteristic in each female of reproductive age that presents with the triad of amenorrhoea, unusual vaginal bleeding and abdominal irritation. It ruptures at a more sophisticated stage of gestation when compared with tubal ectopic pregnancy. Bleeding in interstitial ectopic pregnancy rupture is above that other ectopic pregnancies, also its life-threatening. Interstitial ectopic pregnancy rupture is two to five times greater compared to maternal mortality rate than tubal ectopic pregnancy rupture. Developing gestational sac causes uterine disruption and following hemorrhagic shock, resulting in morbidity and mortality. Clinics that aim to reduce maternal mortality should be much more concerned about convenient disclosure of this abnormal pregnancy condition.

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ASUHAN KEBIDANAN PADA NY. T USIA 28 TAHUN P1A2 POST CURETTAGE ATAS INDIKASI KEHAMILAN EKTOPIK TERGANGGU DENGAN TINDAKAN LAPAROTOMI DI RUMAH SAKIT SANTA ELIS

Elisabeth Health Jurnal ◽

10.52317/ehj.v3i1.231 ◽

2018 ◽

Vol 3 (1) ◽

pp. 28-37

Author(s):

Lismawati . ◽

Ria Oktaviance

Keyword(s):

Maternal Mortality ◽

Pregnant Women ◽

Ectopic Pregnancy ◽

Final Report ◽

Midwifery Care ◽

Study Approach ◽

High Prevalence ◽

Life Threatening ◽

Ectopic Pregnancies

Ectopic pregnancies are impaired including high-risk pregnancies that can be marked by either spotting or moderate bleeding that can be life-threatening to the mother. Based on worldwide WHO research, there is a maternal mortality of 500,000 lives per year and infant mortality in particular 10 million neonates per year. More than 60% of ectopic pregnancies occur in women aged 20-30 with low socio-economic and live in areas with high prevalence ofgonorrhea and tuberculosis prevalence. In Indonesia the maternal mortality rate is 330/100,000 live births. Maternal mortality is estimated at about 16,500-17,500 per year. One-third of them are due to falling-out services.Goals : Performing a Craving Care in Pregnant Women Mrs.T Age 28 years old G3P1A1 with Disturbed Ectopic Pregnancy using a seven step Varney approachMethods:Using descriptive method with case study approach implemented by author through approach of midwifery management. The case observed by the author in this Final Report is Mrs. T Age 28 years G3P1A1 with Disturbed Ectopic Pregnancy at Saint Elizabeth Hospital Medan Year 2018.Results: Gain real experience on the implementation of Midwifery care in pregnant women with Disturbed Ectopic Pregnancy at Saint Elizabeth Hospital Medan. Implementation of midwifery care in pregnant women with Disturbed Ectopic Pregnancy at Saint Elizabeth Hospital Medan is in accordance with the existing theory and hope can be used as input by students so as to provide broad insight into the quality of midwifery services according to midwifery care.Conclution : Standards through the approach of midwifery care management in pregnant women with Disturbed Ectopic Pregnancy.

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Ectopic pregnancy at Soavinandriana hospital center, Antananarivo, Madagascar

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20183238 ◽

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.

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Utility of a routine ultrasound for detection of ectopic pregnancies among women requesting abortion: a retrospective review

BMJ Sexual & Reproductive Health ◽

10.1136/bmjsrh-2020-200888 ◽

2020 ◽

pp. bmjsrh-2020-200888

Author(s):

Clara I Duncan ◽

John J Reynolds-Wright ◽

Sharon T Cameron

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Clinical Care ◽

Significant Risk ◽

Intrauterine Pregnancy ◽

Retrospective Case ◽

Case Record ◽

Ultrasound Findings ◽

Ectopic Pregnancies ◽

Record Review

IntroductionRoutine ultrasound may be used in abortion services to determine gestational age and confirm an intrauterine pregnancy. However, ultrasound adds complexity to care and results may be inconclusive, delaying abortion. We sought to determine the rate of ectopic pregnancy and the utility of routine ultrasound in its detection, in a community abortion service.MethodsRetrospective case record review of women requesting abortion over a 5-year period (2015–2019) with an outcome of ectopic pregnancy or pregnancy of unknown location (PUL) at a service (Edinburgh, UK) conducting routine ultrasound on all women. Records were searched for symptoms at presentation, development of symptoms during clinical care, significant risk factors and routine ultrasound findings.ResultsOnly 29/11 381 women (0.25%, 95% CI 0.18%, 0.33%) had an ectopic pregnancy or PUL (tubal=18, caesarean scar=1, heterotopic=1, PUL=9). Eleven (38%) cases had either symptoms at presentation (n=8) and/or significant risk factors for ectopic pregnancy (n=4). A further 12 women developed symptoms during their clinical care. Of the remaining six, three were PUL treated with methotrexate and three were ectopic (salpingectomy=2, methotrexate=1). In three cases, the baseline ultrasound indicated a probable early intrauterine pregnancy.ConclusionsEctopic pregnancies are uncommon among women presenting for abortion. The value of routine ultrasound in excluding ectopic pregnancy in symptom-free women without significant risk factors is questionable as it may aid detection of some cases but may provide false reassurance that a pregnancy is intrauterine.

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CLINICAL PROFILE OF ISOLATED SYSTOLIC HYPERTENSION AND IT'S CARDIOVASCULAR AND RENAL COMPLICATIONS AT AIIMS, PATNA, BIHAR

10.36106/ijsr/5427239 ◽

2020 ◽

pp. 40-42

Author(s):

Rajeev Ranjan Kumar ◽

Shiv Kumar ◽

Ravikirti Ravikirti ◽

Debarshi Jana

Keyword(s):

Risk Factors ◽

Creatinine Clearance ◽

Systolic Hypertension ◽

Cross Sectional Study ◽

Clinical Profile ◽

Isolated Systolic Hypertension ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test ◽

Associated Risk Factors

Hypertension, its risk factors and complications is very poorly understood therefore it goes undiagnosed and untreated for a long time. The present study was undertaken to study the clinical profile of isolated systolic hypertension (systolic > 140 and diastolic ≤ 90 mmHg ) in elderly (above the age of 60 years)and to find out any other associated risk factors, any end organ complications, specially cardiac through electrocardiography and echocardiography and on kidney through creatinine clearance. The present cross-sectional study was undertaken on patients attending the outdoor department and indoor department of medicine. The study group comprised of 75 elderly patients who had isolated systolic hypertension (ISH). Using Chi square test correlation of age with stage of BP, association of risk factors with ISH and Stage III BP and ECG changes with LVH calculated. It concluded that ISH associated with risk factors has definite effect mainly on cardiac in terms of LV hypertrophy and on kidney in terms of reduced creatinine clearance and is an even better predictor of mortalityand morbidity than is diastolic blood pressure.

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Ectopic pregnancy at the Gambian Tertiary hospital

African Health Sciences ◽

10.4314/ahs.v21i1.38 ◽

2021 ◽

Vol 21 (1) ◽

pp. 295-303

Author(s):

Matthew Anyanwu ◽

Grace Titilope

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Hospital ◽

Clinical Feature ◽

Chi Square ◽

Mortality And Morbidity ◽

Significant Burden ◽

Incidence Risk ◽

Ectopic Pregnancies ◽

The Tropics

Background/Aims: Ectopic pregnancy is a gynaecological emergency with significant burden of maternal mortality and morbidity in the tropics. The incidence reported in the literature range from 1:60 to 1:250 pregnancies. The aim was to determine incidence and risk factors of ectopic pregnancy in the Gambia. Methodology: A longitudinal study of ectopic pregnancy at Gambian tertiary hospital from January 2016 to April 2018. Data was collected from patients’ folders, entered into SPSS version 20 and analysed with de- scriptive statistics. The test of variation and significance was by ANOVA and Chi-square respectively with error margin set at 0.05 and confidence interval of 95%. Results: A total number of 2562 pregnancies were recorded, 43 were ectopic pregnancies. The estimated incidence was 0.2%. Majority of the patients were between 26 – 35 years (56%), primiparous (32%), heterogeneous marriage (82%) and housewives (86%). Occupation was not associated with ruptured or unruptured ectopic pregnancy (p-0.421). Low parity was associated with more ectopic pregnancy than high parity (p-0.001). The commonest clinical feature was abdominal pain (65.1%), whilst the most prominent risk factors were pelvic inflamma- tory disease (27.9%) and previous abortion (23.3%). Ectopic pregnancy was seasonal. Conclusion: The incidence rate of 0.2% was in the range reported in the literature. Low parity, previous abortion and pelvic inflammatory disease were the risk factors. Keywords: Ectopic; pregnancy; incidence; risk factors.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20195330 ◽

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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