scholarly journals Review of ectopic pregnancy at tertiary care center: 2 years analysis

2020 ◽  
Vol 9 (10) ◽  
pp. 4036
Author(s):  
Suman S. Sharma ◽  
Ashish V. Gokhale ◽  
Shonali Agarwal ◽  
Dimpi Modi ◽  
Kajal Gedia
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Diagnostic Methods ◽  
Pelvic Surgery ◽  
Contraceptive Device ◽  
Identifiable Risk Factor ◽  
History Of ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is defined as any intra or extra-uterine pregnancy in which the fertilized ovum implants at an aberrant site which is inconducive to its growth and development. It is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergencies affecting approximately 2% of all pregnancies. The purpose of this study is to review cases of ectopic pregnancy and determine: incidence, high risk factors, types of clinical presentation, diagnostic methods, management, morbidity and mortality.Methods: The present study, conducted over a period of 2-year, total number of deliveries was 16,144 and total number of ectopic pregnancies was 116. More than half of the cases (56.04%) had one or the other identifiable risk factor. Results: Amongst the various risk factors studied, history of previous pelvic surgery (15.43%), history of Pelvic inflammatory disease (PID) (12.9%), use of Intrauterine contraceptive device (IUCD) (10.3%) and either spontaneous or induced abortion (7.76%) has been found. History of self-administered medical termination of pregnancy (MTP) pill was present in 3.45%. Repeat ectopic pregnancies were seen in 1.72%. There was no identifiable risk factor in 49.63% of cases.Conclusion: Ectopic pregnancy is a major challenge in obstetrical practice because of its varied clinical presentation. It can be diagnosed early by keeping a high index of suspicion. Undue delay in referral reduces significant morbidity and improves the chances of preserving future fertility. Mass education regarding safe abortion practices and post abortal care should be promoted. Unsupervised usage of MTP pill intake should be condemned. 

scholarly journals Analysis of various types of ectopic pregnancies: a five-year review

2018 ◽  
Vol 7 (6) ◽  
pp. 2410
Author(s):  
Maheswari S. ◽  
Poornima C. ◽  
Lalitha N. ◽  
Seetha Panicker
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
First Trimester ◽  
Reproductive Age ◽  
Morbidity And Mortality ◽  
Pelvic Surgery ◽  
Main Role ◽  
Contraceptive Device ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy (EP) is a common, life threatening emergency during the first trimester and a significant cause for maternal morbidity and mortality. In any woman of reproductive age presenting with abdominal pain and vaginal bleeding, ectopic pregnancy should be considered. The objectives of the present study is to determine the incidence, risk factors, clinical presentation, type of ectopic pregnancy, treatment, morbidity and mortality.Methods: Retrospective analysis of case sheets of patients admitted with ectopic pregnancy at PSGIMSR, Coimbatore during the period July 2011 to June 2016 was done. The details noted were age, parity, risk factors {previous abortion, previous EP, previous pelvic surgery, intrauterine contraceptive device, tubectomy, history of pelvic inflammatory disease}, treatment for infertility, clinical presentation, ultrasound findings, investigations including beta HCG value and hemoglobin level, treatment offered, need for blood transfusion, operative findings and morbidity.Results: During the five year, there were 12,407 deliveries at our hospitals and 88 cases of ectopic pregnancies were managed. The incidence is 6.6/1000 deliveries. Among them 44% belonged to the age group of 25-30 years and multi gravida were 73.8%. Most common risk factors were previous abortion (23.8%) and previous surgeries including caesarean section, tubectomy, appendicectomy, tubal microsurgery (23.8%). Most common presentation was pain abdomen (85.2%). Out of the 88 cases, 73 patients were managed surgically (82.9%) and 11 cases were managed successfully with methotrexate (12.5%). Three of them underwent conservative management and one had Uterine Artery Embolization.Conclusions: Early diagnosis based on risk factors and timely intervention plays a main role in reducing morbidity and mortality associated with ectopic pregnancy.

Risk Factors for Ectopic Pregnancy: A Multi-center Case Control Study

2021 ◽  
Author(s):  
Nooria Atta ◽  
Fahima Aram ◽  
Nafisa Naseri ◽  
Mahbooba Sahak
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Ectopic Pregnancy ◽  
Case Control Study ◽  
Case Control ◽  
Pelvic Surgery ◽  
Control Group ◽  
Case Group ◽  
History Of ◽  
Control Study

Abstract Background: Ectopic pregnancy (EP) is defined as a pregnancy in which fertilized oocyte implants outside the endometrial cavity. Although there is no known etiology for ectopic pregnancy, some risk factors of EP have been determined. It has been evident that ectopic pregnancy can be of multifactorial origin. This multicenter research aims to study risk factors associated with increased risk of ectopic pregnancy in women living in Kabul. Methods: A multicenter case control study was conducted in five tertiary maternity hospitals located in Kabul, Afghanistan. A total of 457 pregnant women were included in this study. In the case group, women with diagnosed ectopic pregnancy, while in control group women with intrauterine pregnancy were included. For each case in this study, two controls were enrolled. Results: The mean (SD) age of women in case group was 27.9 (6) years while in control group it was 26.4 (5.5) years. This difference was not statistically significant. We found a significant association between history of abortion and EP (Adj. OR=1.57; 95%CI: 1.02, 2.42). Having history of abdominal/pelvic surgery was a risk factor for EP with adjusted OR 1.94 (95%CI: 1.15, 3.30). In this study we found an increasing risk of EP in women of 35 years or older compared to younger women (Crude OR=2.26; p= 0.024). In women reporting prior EP, the chance of its recurrence was increased (Crude OR= 9.64; 95%CI: 1.1, 83.2). No association of gravidity and parity was found with EP incidence. Conclusions: In this study we found a statistically significant association between history of abdominal/pelvic surgery and EP. In addition, history of abortion was suggested as a risk factor for ectopic pregnancy. In case of having a previous EP probability of its recurrence will be increased. Women with advanced age having other potential risk factors will be facing higher risk of EP.

scholarly journals Association of Risk Factors of Ectopic Pregnancy

2017 ◽  
Vol 1 (2) ◽  
pp. 26-32
Author(s):  
Dur e Shehwar ◽  
Lubna Zubair
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Low Socioeconomic Status ◽  
Uterine Cavity ◽  
Pelvic Surgery ◽  
Contraceptive Device ◽  
Assisted Reproductive Technique ◽  
History Of ◽  
Tubal Disease ◽  
Reproductive Technique

Abstract:Background: Ectopic pregnancy is the implantation of a fertilized ovum anywhere outside the uterine cavity. Around 95% of ectopic pregnancies occur in the Fallopian tubes. Most of these are occurring in the ampulla region. Other sites include the interstitial or the corneal region of the myometrium, cervix, ovary, peritoneal cavity (abdominal pregnancy) and in caesarean section scars. The objective of this study was to see the association of different risk factors of ectopic pregnancy.Methodology: It was a case-control study. The data was collected from Obstetrics & Gynaecology department Jinnah Hospital, Lahore and the study was completed at Gulab Devi PGMI, Lahore. For the analysis of data, SPSS version 16.00 was used.Results: 180 pregnant females were taken in which 90 were cases and 90 were controls. 16 females were more than 35 years in age of which 16% females had ectopic pregnancy. There were 3 females had history of smoking in which 3% females had ectopic pregnancy. There were 82 females who had history of pelvic surgery in which 43% female had ectopic pregnancy. There were 17 females have had history of previous ectopic pregnancy of which 14% were having ectopic pregnancy. There were 6 females have had history of IUCD (Intra uterine contraceptive device) of which 6% females were having ectopic pregnancy. There were 23 females who had history of PID (Pelvic inflammatory disease) of which 26% females were having ectopic pregnancy. There were 2 females have had history of tubal disease and had ectopic pregnancy. There were 21 females who had history of ART (Assisted reproductive technique) in which 3% females were presented with ectopic pregnancy. There was 1 female who had history of endometriosis in which 2% females were presented with ectopic pregnancy.There were 16 females have had history of low socioeconomic status of which 9% females were presented with ectopic pregnancy. There was 1 female who had history of tuberculosis and having ectopic pregnancy.Conclusion: In the present study age more than 35 years, smoking, previous ectopic pregnancy, insertion of IUCD, PID, assisted reproductive technique, tubal disease, history of pelvic surgery, endometriosis and tuberculosis had a great association with ectopic pregnancy.

scholarly journals Clinical outcomes of ectopic pregnancy

2017 ◽  
Vol 6 (10) ◽  
pp. 4277
Author(s):  
Roopa Malik ◽  
Shaveta Jain ◽  
Nirmala Duhan ◽  
Daya Sirohiwal
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Past History ◽  
Management Strategies ◽  
Emergency Laparotomy ◽  
Mortality And Morbidity ◽  
History Of ◽  
Ectopic Pregnancies ◽  
A Prospective Study

Background: Ectopic pregnancy (EP) is a life threatening gynaecological emergency, and a significant cause of maternal mortality and morbidity worldwide. Aim of this study was to determine and evaluate the incidence, clinical presentation, risk factors, management strategies and outcome of the patients with EP.Methods: This was a prospective study of all cases of ectopic pregnancies admitted and managed at PGIMS Rohtak over a period of 1 year. All patients admitted through accident and emergency unit as well as the gynaecology clinic that were managed in gynaecological ward were included in the study. The diagnosis of EP was made by history, clinical examination, urinary pregnancy test and ultrasound examination. Patients were managed as per hospital protocol and relevant data on age, parity, clinical presentation, risk factors, management and findings at laparotomy, and the outcome of treatment were collected.Results: The incidence of ectopic pregnancy in this study was 1.056%. The mean age of the patients was 27±3 years. Of the 102 ectopic pregnancies, 86 (84.31%) were ruptured ectopic pregnancies, while 16 (15.68%) were unruptured ectopic pregnancies. The commonest clinical complaint was abdominal pain (97 of 102, 95.09%) History of previous abortion (induced or spontaneous) was the commonest risk factor (92 of 102, 90.19%) followed by past history of pelvic inflammatory disease (56 of 102, 54.90%). History of tubal surgery was present in 27 of 102 patients (26.47%). commonest surgical procedure done was emergency laparotomy followed by salpingectomy (67 of 102, 65.68%).Conclusions: EP is an important cause of maternal morbidity and mortality in early pregnancy and has remained a reproductive health challenge. Early diagnosis and treatment can improve reproductive outcomes. 

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 Management outcomes of ectopic pregnancy depending on different treatment modalities: a cohort study

2021 ◽  
Vol 10 (3) ◽  
pp. 842
Author(s):  
Shawqi H. Alawdi ◽  
Mayada Roumieh ◽  
Marwan Alhalabi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Single Dose ◽  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Expectant Management ◽  
Pelvic Surgery ◽  
Dose Methotrexate ◽  
Significant Difference ◽  
History Of

Background: Ectopic pregnancy is the most common cause of maternal morbidity and mortality during the first trimester of pregnancy. The present study aimed to review and evaluate the management outcomes of ectopic pregnancy in Damascus University Maternity Hospital, Syria.Methods: A retrospective cohort study was performed on women referring to Damascus University Hospital of Obstetrics and Gynecology (OBGYN) for ectopic pregnancy. Patients were assigned into groups by method of treatment: expectant management (Group 1), single-dose methotrexate regimen (Group 2), two-dose methotrexate regimen (Group 3), and surgical intervention (Group 4). Parameters assessed were risk factors for ectopic pregnancies, transvaginal ultrasonography findings, serum human chorionic gonadotropin (hCG) levels on Days 0, 4, 7, and types of surgical intervention in women that underwent any surgical intervention. A treatment modality was considered successful when hCG levels declined to less than 5 mIU/L without further administration of methotrexate dose or need for surgery.Results: Seventy-seven women with ectopic pregnancy were admitted to the hospital during the study period. Groups 1, 2, 3, and 4 constituted 20.8%, 13.0%, 6.5% and 59.7% of the patients respectively. The most common encountered risk factors for ectopic pregnancy in the patients were history of previous intra-abdominal or pelvic surgery (57.1%) and history of miscarriage (41.6%). A statistically significant difference in the serum hCG concentrations measured on day 0, day 4, and day 7 were observed between the groups.Conclusions: The success rate in ectopic pregnancy treatment was 56.25% for the expectant management, 70% for the single-dose methotrexate regimen, and 40% for two-dose methotrexate regimen.

scholarly journals RISK FACTOR OF ECTOPIC PREGNANCY BY USING LITERATURE REVIEW METHOD

2021 ◽  
Vol 5 (3) ◽  
pp. 277
Author(s):  
Winda Fatma Sari ◽  
Adityawarman Adityawarman ◽  
Budiono Budiono
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Literature Review ◽  
Ectopic Pregnancy ◽  
Exclusion Criteria ◽  
Mortality And Morbidity ◽  
Pregnancy History ◽  
Major Predictor ◽  
History Of

Background: Ectopic pregnancy is a pregnancy outside the uterus, embryo could attached to thefallopian tube, ovary cervix or cervix. Around 85-90% incidence of ectopic pregnancy is found inmultigravid women. According to data from the Health Office, maternal mortality in 2017 tendsto increase in the last two years. Not only it is a major predictor of mortality and morbidity inpregnant women, but individuals with a history of ectopic pregnancy have a greater risk. Thepurpose of this research was to determine the risk factors that cause ectopic pregnancy by usingliterature studies review. Method:This study used a systematic review of articles that publishedbetween 2013-2020 in the Science Direct, Scopus and Google Scholar. 10 articles that meet theinclusion and exclusion criteria, included as a sample for further review. The results regarding torisk factors that caused ectopic pregnancy in each article were systematically synthesized. Results:Risk factors found to be significantly associated with the incidence of ectopic pregnancy in thearticle were age (2), infertility (2), IUD (3), PID (3), Ectopic Pregnancy History (5), Progestine Pills (2), History of Abortion (1), Smoking (3). Conclusions: age, infertility, IUD, PID, history of ectopic pregnancy, progestine pill, History of abortion, and smoking were risk factors that hadsignificant relationship with the incidence of ectopic pregnancy.

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 Clinical Study of Ectopic Pregnancies in a Tertiary Care Hospital of Chittagong, Bangladesh

2014 ◽  
Vol 13 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Most. Sabina Yeasmin ◽  
M Jalal Uddin ◽  
Enamul Hasan
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Clinical Presentation ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
History Of

Background: Motherhood, an eternal, universal and inherent dream which every woman has. This dream may not always be pleasant and it can involve nightmares. One of this is ectopic pregnancy: A pregnancy which can be life threatening. Aims : 1. To know the age group, parity, gestational age and the risk factors with re-spect to the ectopic pregnancy. 2. To know the clinical presentation of the ectopic pregnancy. 3. To know the treatment and morbidity and mortality associated with ectopic pregnancy.Materials & methods : A total of 47 admitted patients who were di-agnosed as ectopic pregnancy cases were retrospective analyzed between the periods from January 2013 to June 2014 at Chattagram Maa-O-Shishu Hospital Medical College, Agrabad, Chittagong. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultrasonogram and at surgery and morbidity associated with ectopic pregnancy were noted.Results: The incidence of the ectopic pregnancy in the pres-ent study was 7.4/1000 deliveries. A majority of the cases were multigravidas and majority of the cases gestational age were six to ten weeks. In most of the cases, there were no identifiable risk factors. The commonest risk factors present were history of MR (12.7 %)and abortion (10.6), history of tubal surgery (2.2%), infertility (2.2%) and pelvic inflammatory diseases (4.2%).The commonest symptoms were abdominal pain (89.3%), amenorrhea (78.7%) and abnormal vaginal bleeding (63.5%); and commonest signs were abdominal tenderness (70.5%), cervical excitation (52.6%) and adnexal tenderness (50.4%). Almost half (45%) were in a state of shock at admission. Ultrasound, a urine pregnancy test and serum B-hCG were the investigative modalities which were used. Surgery by open method in the form of salpingectomy (92.3%), salpingo-oophorectomy (5.5%) and salpingostomy (2.1%) were the mainstay of management. Morbidity included anemia (50.9%), blood transfusion (78%) and wound infection (2.1%). No maternal mortality noted.Conclusion: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.20993  

Ectopic Pregnancy - A 1 Year Clinical Study in King George Hospital, Visakhapatnam

2021 ◽  
Vol 8 (27) ◽  
pp. 2457-2461
Author(s):  
Vamsi Mudadla ◽  
Shyamala Kaitala ◽  
Satyavani Nandigama
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
High Index ◽  
Diagnostic Methods ◽  
Obstetric Emergency ◽  
King George Hospital ◽  
High Index Of Suspicion

BACKGROUND Ruptured ectopic is a life threatening obstetric emergency. Obstetrician must have a high index of suspicion for ectopic pregnancy and should be aware of importance of early diagnosis and early intervention. The present study was undertaken to evaluate the incidence, clinical presentation, risk factors, treatment and morbidity associated with ectopic pregnancy. METHODS Retrospective analysis of ectopic pregnancy was done in King George Hospital, Visakhapatnam from January 2020 to December 2020 in the department of OBG. The following parameters: Age, risk factors, clinical presentation, site of ectopic, diagnostic methods, mode of treatment were noted. RESULTS A total of 63 cases were reported during this time frame. It is a tertiary care centre getting referrals from nearby districts and other hospitals. Incidence of ectopic pregnancy in the present study is 0.89 %. 41.26 % of patients belonged to age group between 26 to 30 years. Out of 63 cases 49.20 % were multigravida. 28 % of the cases were associated with previous H/O abortions and 23 % of the cases were associated with PID and in 17.4 % of the cases there was no predisposing factors. 96.82 % the patients presented with pain abdomen. Shock in 34.92 % of the cases. Ampulla is the most common site of ectopic. In 76 % of the cases there was hemoperitoneum > 500 ml. Salpingectomy was done in 79.3 % cases. 84 % of cases required blood transfusion > 1 unit. There was no mortality. CONCLUSIONS Ectopic pregnancy is one of the obstetric emergency with significant morbidity and mortality. PID and post abortal sepsis are one of the important risk factors for ectopic pregnancy. As many patients may not have recognizable risk factors, a high index of suspicion is critical for early diagnosis. Early USG diagnosis of ectopic pregnancies reduces mortality and enables us to offer the patient conservative medical and surgical treatment. KEYWORDS Ectopic Pregnancy, TVS, Ampulla, Salpingectomy

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