scholarly journals Epidemiology of ectopic pregnancy at Laquintinie Douala hospital (Cameroon): prevalence survey, clinical profile, therapeutic and transfusion issues

Author(s):  
Henri Essome ◽  
Thomas O. Egbe ◽  
Gregory E. Halle ◽  
Théophile N. Nana ◽  
Merlin Boten ◽  
...  

Background: Pregnancy is a serious pathology of the first trimester of pregnancy and is the leading cause of death. The objective of our work was to determine the hospital prevalence of ectopic pregnancy (EP), to describe the epidemiological, clinical and therapeutic profile given the often-haemorrhagic context at Laquintinie Hospital in Douala.Methods: We carried out a retrospective study over 10 years, from January 1st, 2007 to December 31st, 2016, using the operating theatre registers and the files of patients admitted during this period for ectopic pregnancy in the gynaecology and obstetrics department of the Laquintinie Hospital in Douala.Results: A total of 905 cases of EP for 32,595 deliveries were recorded, for an overall incidence of 2.8%. EP mainly affected the age group of 25 to 35 (60.6%), single people (57.9%) and housewives (46.6%). The risk factors found were similar to those of cervical cancer, namely multiple sexual partners (80.4%), the precocity of sexual intercourse under 18 years (54.1%) and sexually transmitted infections (52.5%). The symptomatic triad (pelvic pain, amenorrhea and metrorrhagia) was found in 46.1% of cases with a respective order of frequency of 96.9%, 77.3% and 63.6% The management was essentially surgical by radical laparotomy (97% of cases). Two of the 07 deaths were due to religious considerations.Conclusions: EP remains a frequent pathology in our environment with a heavy toll of tubal amputations and death.

Author(s):  
Beera Neelima ◽  
V. G. Vanamala

Background: Over the years, there has been a considerable rise in the incidence of ectopic pregnancy. This study was undertaken to identify the risk factors that contribute to this condition, so that immediate action can be taken so as to save the mother.Methods: 62 women, in their first trimester of pregnancy who were diagnosed with ectopic pregnancy were included in the study. Demographic details, clinical and obstetric details were taken from all the patients. Ultrasound was performed to confirm the ectopic pregnancy.Results: Out of the 62 patients, most of them with ectopic pregnancy were found to be in the 26-30 (40.3%) year’s age group. Smoking, whether active or passive was observed in nearly 42% of the cases. The mean gravid status among the women was 3, with 34 live births. 21 of them had induced abortions and 4 were spontaneous. PID was observed in 12 patients (19.4%), 17.7% were IUD users.Conclusions: Risk factors such as previous ectopic pregnancy, use of contraceptives, infertility, PID, abortion as well as increased maternal age aid in the early detection of ectopic pregnancy in women resulting in proper and timely treatment.


Author(s):  
Md. Jakir Hossain ◽  
Muhammad Afser Siddiqi ◽  
M. Mostafizur Rahman ◽  
Khairun Nahar Khan ◽  
Ahmed Imtiaj

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Like other sexually<strong> </strong>transmitted diseases (STD), ano-genital warts (AGW) is associated with human immunodeficiency virus (HIV) infection and this study of AGW was conducted among HIV positive and HIV negative patients. The aim of the study was to study the risk factors and clinical presentations of ano-genital warts in HIV infected patients</span>.</p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A comparative, cross-sectional, descriptive study of 25 HIV positive and 25 HIV negative (n=50) AGW patients between 15-60 years of both sex was conducted in Northern part of Bangladesh from July 2015 to December 2016. </span><span lang="EN-IN"> </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Significant association of HIV positivity (p&lt;0.05) was<strong> </strong>observed between age group of 15-30 years and HIV negative status (p&lt;0.05) in age group of 31-45 years. HIV positive status significantly higher in patients with self-admitted multiple sexual partners (p&lt;0.01), homosexuality (p&lt;0.05) and presentation with anal warts (p&lt;0.01). HIV negative status correlated significantly with single sexual partner admission (p&lt;0.01) and hetero-sexuality (p&lt;0.05). Gender did not show significant association with number of sexual partners or HIV positivity. Extra-genital or only genital warts had no association with HIV status. Co-STDs though more in number in seropositive group, did not show any significant association with HIV positivity (p&gt;0.05). No patient presented with changes of malignancy. Four were adolescents below 19 years. Two patients had atypical presentations of giant condylomata i.e., Buschke-Lowenstein tumour (BLT)</span>.</p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">HIV positivity was significantly associated with<strong> </strong>the risk factors of age below 30 years, homo sexuality and multiple sexual partners. Anal warts were significantly common in HIV positive patients. Four adolescents with AGW underline the need for high risk behaviour counselling. No patient had malignant AGW. Follow up of these patients with human papilloma virus (HPV) sub-typing is necessary. </span></p>


2020 ◽  
Vol 4 (3) ◽  
pp. 645-655
Author(s):  
OLOBO F. AWULU ◽  
Mariam Aminu ◽  
A. B. SULEIMAN ◽  
DANIEL MAKOLO

Analysis of prevalence and risk factors for Human Papilloma Virus (HPV) is the basis for prophylactic strategies against HPV infections. This study was to determine the seroprevalence of human papillomavirus, sociodemographic and risk factors associated with acquiring the virus among the study population. A total of 195 samples were collected by simple random sampling technique from three major hospitals in the zone. Serum from blood samples was used for ELISA and analyzed for IgM. Overall prevalence of 3.08% (6/195) was established for HPV infection. Patients with early sexual activity and those with multiple sexual partners were likely to be infected than their counterparts with 15.8%: 3/19 (χ 2 =16.4, df=3, p=0.001) and 50%: 2/4 (χ 2 =30.2, df=1, p=0.005) respectively. The infection was more among those who got married at age range of 26-30 years with prevalence of 5.4%: 2/37 (χ 2 =1.30, df = 5, p=0.82). On the basis of sex, female were found to have higher prevalence of 3.6%: 6/167(χ 2 =1.04, df = 1, p=0.6). Subjects with sexually transmitted disease (STD) had a higher prevalence of 8%: 2/25(χ 2 =2.45, df=2, p=0.32). The study shows that infection with HPV was strongly associated with age of sexual debut and number of sexual partners. It also reveals the occurrence of HPV infection in Kogi East, Nigeria. Hence, there is need for routine screening, public education and vaccination to prevent the spread of the virus which is a threat to public health.


Author(s):  
Naorem Sunanda Chanu ◽  
Vinodkumar Suresh Basavaradder ◽  
Cibi Darsani ◽  
Ahanthembi Sanaton

Background: Ectopic pregnancy is one of the most common life-threatening emergencies in early trimester of pregnancy. The aim of this study was to determine the incidence, age group, gravidity, parity, risk factors, clinical presentation, treatment modalities associated with ectopic pregnancy in the current scenario.Methods: We conducted a prospective study for the period of two years starting from Aug 2017 to Aug 2019 at JNIMS OBG Department.Results: A total of 94 patients who were diagnosed as ectopic pregnancy and they were analysed for clinical presentation, risk factors, operative findings and treatment modality. Majority of patients were in the age group of 25 to 30 years. Ectopic pregnancy was more commonly associated with history of prior abortions, prior LSCS and PID. Commonly presented with amenorrhea of 6-8 weeks with abdominal pain and bleeding PV, most common site being ampulla followed by isthmus. Most of the patients had ruptured pregnancy at presentation. Majority of the patients underwent salpingectomy and salpingectomy with contralateral tubectomy.Conclusions: Ectopic pregnancy diagnosis is a grey zone and challenging. Early diagnosis by keeping suspicion in first trimester with PV bleeding and pain abdomen with history of amenorrhea about ectopic pregnancy, which helps in management to reduce maternal morbidity and even mortality.


2018 ◽  
Vol 5 (2) ◽  
pp. 33
Author(s):  
Kadek Yulita Dewi Lestari ◽  
Desak Nyoman Widyanthini ◽  
I Ketut Tangking Widarsa

ABSTRAK Infeksi Menular Seksual (IMS) adalah infeksi yang penularannya terutama melalui hubungan seksual. Di Indonesia, jumlah kasus IMS pada tahun 2014 terjadi sebanyak 5608 kasus. Dinas Kesehatan Provinsi Bali mencatat jumlah pasien IMS yang ditemukan pada tahun 2013 sebanyak 9.202 orang. Jumlah ini meningkat sebanyak 62,17% pada tahun 2014 dan mengalami penurunan sebanyak 61,82% pada tahun 2015. Data yang diperoleh dari Dinas Kesehatan Kota Denpasar menunjukkan bahwa dari keseluruhan kasus di Kota Denpasar pada tahun 2016, kasus IMS tertinggi berada di wilayah Puskesmas II Denpasar Utara yaitu sebanyak 36,94 %. Tujuan penelitian ini adalah untuk mengetahui kejadian IMS berdasarkan karakteristik sosial demografi meliputi jenis penyakit, umur, jenis kelamin, pendidikan terakhir, status perkawinan, pekerjaan, kelompok risiko, pemakaian kondom dan jumlah pasangan seksual pada bagian IMS di Puskesmas II Denpasar Utara tahun 2014-2016.  Penelitian ini merupakan penelitian deskriptif dengan desain penelitian cross sectional retrospektif. Populasi dan sampel pada penelitian ini adalah seluruh pasien yang berkunjung ke Klinik IMS Puskesmas II Denpasar Utara periode tahun 2014-2016 yang diperoleh secara total sampling. Data sekunder yang diperoleh selanjutnya diolah secara statistik dengan menggunakan stata.  Hasil penelitian menunjukkan bahwa kejadian IMS lebih tinggi pada kelompok umur 41-50 sebanyak 25%, subjek laki-laki sebanyak 26,4%, tidak pernah sekolah sebanyak 12,5%, subjek dengan status kawin sebanyak 37,6%, pekerjaan berisiko sebanyak 25,5%, kelompok WPS sebanyak 60%, subjek yang kadang-kadang memakai kondom sebanyak 18,2% dan jumlah pasangan seksual >1 sebanyak 39,4%.  Kesimpulan dari penelitian ini adalah kejadian IMS di Puskesmas II Denpasar Utara tahun 2014-2016 yaitu 7,4%-13%. Kejadian IMS lebih tinggi pada kelompok umur 41-50 dengan pekerjaan berisiko, kelompok WPS dan jumlah pasangan seksual >1. Tiga jenis IMS yang paling sering terjadi di Puskesmas II Denpasar Utara dalam 3 tahun terakhir yaitu Urethritis Non-GO disusul Servisitis dan Kandidiasis. Diharapkan sasaran dalam pelaksanaan program IMS tidak hanya bagi penderita namun juga bagi pasangannya dan tidak hanya menyasar kelompok risiko seperti WPS namun juga pelanggan PS. Kata Kunci: Kejadian, IMS, karakteristik, cross sectional retrospektif     ABSTRACT Sexually transmitted infections (STIs)  are transmitted infections mainly through sexual contact. In Indonesia, the number of STI cases in 2014 reached 5608 cases. The Bali Provincial Health Service recorded 9,202 STI patients found in 2013. This number increased by 62.17% in 2014 and decreased by 61.82% in 2015. Data obtained from the Denpasar City Health Office showed that of all cases in Denpasar City in 2016, the highest STI cases were in the Puskesmas area II North Denpasar as much as 36.94%. The purpose of this study was to determine the incidence of STIs based on socio-demographic characteristics including the type of disease, age, sex, recent education, marital status, occupation, risk group, condom use and number of sexual partners in the STI section at Puskesmas II Denpasar Utara in 2014-2016 . This research is a descriptive study with a retrospective cross sectional research design. The population and sample in this study were all patients who visited the IMS Clinic II North Denpasar Health Center for the period 2014-2016 obtained in total sampling. The secondary data obtained are then processed statistically using stata. The results showed that the incidence of STIs was higher in the 41-50 age group by 25%, male subjects by 26.4%, never attending school by 12.5%, subjects with marital status by 37.6%, occupations at risk as much as 25.5%, FSW group as much as 60%, subjects who sometimes used condoms as much as 18.2% and the number of sexual partners> 1 were 39.4%. The conclusion of this study is the incidence of STIs in Puskesmas II Denpasar Utara in 2014-2016, namely 7.4% -13%. The incidence of STIs was higher in the 41-50 age group with risk jobs, FSW groups and number of sexual partners> 1. Three types of STIs that most often occur in Puskesmas II Denpasar Utara in the last 3 years, namely Non-GO Urethritis followed by Cervicitis and Candidiasis. It is expected that the target in the implementation of the IMS program is not only for sufferers but also for their partners and not only targeting risk groups such as WPS but also PS customers. Keywords: Occurrence, STI, characteristic, retrospective cross sectional


2016 ◽  
Vol 28 (1) ◽  
pp. 9-14
Author(s):  
Kamrun Nahar ◽  
Turani Talukder ◽  
Sabiha Sultana ◽  
Md Anwar Hossain

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


2018 ◽  
Vol 7 (4) ◽  
pp. 467-470
Author(s):  
Wasan Wajdi Ibrahim ◽  
Afraa Mahjoob Al-Naddawi ◽  
Hayder A. Fawzi

Objectives: Assessment of glycodelin (GD) as a marker for unruptured ectopic pregnancy (EP) in the first trimester of pregnancy. Materials and Methods: This case-control study was conducted during June 2016 to May 2017 in the Obstetrics and Gynecological Department of Baghdad University at Baghdad teaching hospital/medical city complex. In this study, 100 pregnant women in their first trimester of pregnancy were included after clinical and ultrasonic findings. Results: Based on the results, GD levels in EP were significantly lower than those with normal intrauterine pregnancy (1.58 ± 1.18 vs. 30.1 ± 11.9). In addition, using receiver operator curve analysis, the cut-off GD level of 9.5 and less had acceptable validity results (100% sensitivity, 100% specificity, 95% positive predictive value, 100% negative predictive value, and accuracy 100%) to predict EP. Conclusions: In general, serum GD is considered as an excellent predictor of unruptured EP.


Author(s):  
Shrusti Parmar ◽  
Nalini Sharma ◽  
Vimla Dhakar

Background: One among the three chief obstetric causes of bleeding in first trimester, ectopic pregnancy is the first thing to rule out as a gestation is suspected. The present study observes and analyses sociodemographic distribution, risk factors, presentation, diagnosis and treatment modalities in a tertiary care centre.Methods: An observational cross-sectional study, conducted among patients who were diagnosed and managed in department of obstetrics and gynaecology of a tertiary care centre. Data analyzed and explained as frequency, percentage, mean and standard deviation.Results: Age group between 21 to 30 years (69.9%) and multigravida (68.5%) are high risk for ectopic pregnancy (EP). Menstrual history was regular in 86.3%. Risk factors identified were previous abortion (30%) and history of pelvic inflammatory disease (30%). In 80.9% pain in abdomen was presenting complaints followed by bleeding per vaginum (60%), amenorrhoea (60%) and nausea and vomiting (32.9%). Right salpingectomy was most common in 43.8%, followed by left salpingectomy in 28.8%, methotrexate in 15.1%, left salpingo-ophorectomy in 5.5%, right salpingo-opherectomy in 5.5% and removal of tubal abortion in 1.3% patients. Laparoscopy was chosen route in majority 64.4% patients.Conclusions: Ectopic pregnancy - a gynecological catastrophe as well as a major challenge to the reproductive performance of women worldwide, should be considered a relevant public health issue. By providing adequate materials, manpower, well-equipped health facilities as well as a prompt and efficient referral system, good access roads and efficient transportation, will ensure early presentation in hospitals and prompt management of cases.


Author(s):  
Indu Verma ◽  
Punya Priya ◽  
Charvi Chugh ◽  
Harsharan Kaur ◽  
Dinesh Sood

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.


2018 ◽  
Vol 8 (1) ◽  
pp. 2-6
Author(s):  
Sangeeta Devi Gurung ◽  
Prakash Sharma

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.


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