scholarly journals Incidence and risk factors associated with ectopic pregnancy: a prospective study

Author(s):  
Harish K. M. ◽  
Shwetha N. ◽  
Nalini N.

Background: Increased incidence of ectopic pregnancy and its impact on women’s fertility in recent years need significant attention.Methods: A two years prospective study from January 2018 to December 2019 conducted to determine incidence, association of risk factors with ectopic pregnancy and find the most common risk factor of ectopic pregnancy in department of obstetrics and Gynaecology, a tertiary care Hospital in Pune.Results: During the study period 100 patients were diagnosed to have ectopic pregnancy. Incidence was 5.29 per 1000 births. Majority were in the age group of 20-24 years (42%), multiparous (59%) and belong to low socioeconomic state (62%). In majority of the patients (22%) no risk factors was found. Among the patients who had risk factors, the main risk factors for ectopic pregnancy were history of history of pelvic inflammatory disease (20%), previous tubal/abdominal surgery (12%), history of Infertility (10%), previous termination of pregnancy (10%), contraception with mirena IUS or IUCD in situ (8%) and a history of prior ectopic pregnancy (4%).Conclusions: In majority (78%) of patients risk factors for ectopic pregnancy was present and pelvic inflammatory disease was found to be a major risk factor for ectopic pregnancy.

Author(s):  
Ranjita Ghadei ◽  
Swayamsiddha Mohanty ◽  
Sushree Sovana Mishra ◽  
Debashis Giri

Background: Ectopic pregnancy is the leading cause of maternal death during the 1st trimester of pregnancy, accounting for approximately 10% of all pregnancy related deaths. A better understanding of ectopic pregnancy risk can help prevent its occurrence. The present study was designed to evaluate the ectopic pregnancy risk factors and their strength of association with ectopic pregnancy at a tertiary care hospital.Methods: It was a prospective study with 104 cases of ectopic pregnancy and 125 controls conducted in the Department of Obstetrics and Gynecology, SCB Medical College, Cuttack for a period of 1 year. Detailed history suggestive of risks factor for ectopic pregnancy, menstrual and obstetrics history was taken. General, systemic, abdominal and vaginal examination was done. Diagnosis of ectopic pregnancy was confirmed by clinical examination, urine pregnancy test, ultrasonography and culdocentesis and only confirmed cases were included in the study group. Healthy pregnant women were taken as control group.Results: The study revealed that the risk of ectopic pregnancy was associated with the traditional risk factors including previous EP [Adjusted odds ratio (AOR) = 9.98, 95% CI: 0.89-11.1%], previous infertility (AOR= 7.29, 95% CI:2.53-21.0) and previous history of sterilization (AOR=12.47,95% CI: 3.50 - 44.4) and previous history of abortion (AOR= 3.10, 95% CI: 1.53-6.30). Age comparison between cases and controls revealed that the ODDS of having ectopic pregnancy was 4 times in the age group 30 to 35 years as compared to uterine pregnancy and this difference was statistically significant (P value = 0.007).Conclusions: Risk factors such as previous ectopic pregnancy, induction of ovulation, intra uterine device usage, abortion as well as increased maternal age along with recent diagnostic tools aid in early detection of ectopic pregnancy in women resulting in proper and timely treatment.


Author(s):  
Jyoti Meena ◽  
Richa Vatsa ◽  
Sunesh Kumar ◽  
Kallol K. Roy ◽  
Anshu Yadav ◽  
...  

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality. For surgical management, laparoscopy is preferred option. In developing world for ruptured ectopic pregnancy laparotomy is done at most of places. In this study we have assessed feasibility of laparoscopic management in both ruptured and unruptured ectopic pregnancy.Methods: A prospective study, conducted over period of 1 year from July 2014 to July 2015 in Department of Obstetrics & Gynecology, All India Institute of Medical Sciences, New Delhi. In 110 patients of ectopic pregnancy parameters studied were age and parity, symptoms, risk factors, diagnostic methods, site of ectopic, management and its outcome. Primary objective was to evaluate management outcome of ectopic pregnancy and to assess feasibility of laparoscopy in ectopic pregnancy. Ruptured ectopic pregnancy with massive hemoperitoneum were analyzed separately. Secondary objective was to study demographic characters and risk factors of ectopic pregnancy.Results: Surgical management was required in 93.6% patients, out of which 86.4% were managed laparoscopically. Unruptured ectopic pregnancy was managed successfully by laparoscopy in 96.6% (29/30) patients. Ectopic was ruptured in 73 (66.3%) cases, laparoscopy was attempted in 91.7% (67/73). In 10.4% (7/67) patients laparoscopy had to be converted to laparotomy and it was successful in 89.5%. Out of 16 patients with massive hemoperitoneum, 12(75%) were managed laparoscopically. There was no mortality.Conclusions: In most of cases laparoscopy is safe and successful. Laparoscopy is feasible in ruptured ectopic cases including selected cases with massive hemoperitoneum thus avoiding unnecessary laparotomy and associated morbidity. Timely diagnosis and management prevents mortality.


2020 ◽  
pp. 1-4
Author(s):  
Dhrubajyoti Choudhury* ◽  
N. C. Borah ◽  
P. S. Deb ◽  
Amit Ranjan Baruah ◽  
Kinzang Wangda ◽  
...  

Cerebrovascular disease include most common devastating disorders :ischaemic stroke and haemorrhagic stroke.The incidence of cerebrovascular disease increases with age and the number of strokes is projected to increase as the elderly population grows.A stroke is the second leading cause of death worldwide. Some of the Indian studies have shown a stroke prevalence of 471.58/100000 population. OBJECTIVE:To study the clinical presentation, risk factors,neurological presentation,pattern of brain strokes,areas of brain affected as per CT/MRI Brain scan findings in a newly admitted patients in GNRC Institute of Medical Sciences, North Guwahati,Assam. METHODS:This is a prospective study included all new patients with stroke admitted in ICU and Ward under Neurology Department of GNRC institute of Medical Sciences ,North Guwahati,Assam,from 1st August,2018 to 31st July ,2019. RESULTS: The cerebrovascular strokes are more common in males (64.4%) than females (35.6%). Most common age group was 58-67 years (28.29%).Most common clinical feature was hemiplegia (71.21%).Most common risk factor was Hypertension (89.51%) followed by diabetes mellitus(51.70%) . Most common type of stroke was haemorrhagic (60.24%) followed by ischaemic (39.75%). In stroke infarct most common involved areas were parietal (13.65%). In hemorrhagic stroke most common site was basal ganglia (21.95%) followed by thalamus (10.97%). CONCLUSION: Males were more commonly affected with cerebrovascular accident with hypertension was the most common risk factor among the stroke patients and most common type of stroke was haemorrhagic.


Author(s):  
Most. Sabina Yeasmin ◽  
M Jalal Uddin ◽  
Enamul Hasan

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  


Author(s):  
Chandana Galidevara ◽  
Swaramya C.

Background: The objective of this study was to analyse distribution of predisposing risk factors for ectopic pregnancy and to study the various modalities of management instituted along with surgical characteristics.Methods: This is a retrospective data analysis of tubal ectopic pregnancies (EP) managed in a tertiary rural referral centre over three years.Results: A total of 160 women were managed for tubal EP. Majority of the women belonged to the age group of 21-30 years (73%). Multigravidae constituted 71.3% of the women and overall, 90.6% women conceived spontaneously. History of ovulation induction was present in 3.7% of women, IUI in 1.2% and IVF in 4.4%. Risk factors encountered in the study include previous EP (9.4%), history of tubal sterilisation (6.9%), caesarean section (13.1%), PID (7.5%), miscarriage (25%), tubal recanalization (3.7%). Conservative management was instituted in 16.8%. Amongst the women managed surgically, 67.5% underwent laparotomy with the remaining being managed laparoscopically. Of the surgically managed patients 72.9% had ruptured EP. There was a predominance of right sided ectopic in our study (79%) and ampullary region of the fallopian tube was the most common site of tubal EP (81.2%). The most common procedure performed was total salpingectomy (56.4%). Supportive treatment with blood transfusion was required amongst 18.8% of the women who had EP. In the postoperative period, fever was noted in 13.5% of women and 2.5% needed intensive care unit admission for hemodynamic stabilisation. The incidence of wound discharge was 12% of women who underwent surgery.Conclusions: This study underpins the importance of early diagnosis, appropriate clinical managementwith timely intervention to improve outcomes associated with EP and to prevent severe morbidity and mortality.


2016 ◽  
Vol 2 (3) ◽  
pp. 35-38
Author(s):  
Dr Fatima Anis ◽  
◽  
Dr Malarvizhi G ◽  
Dr Narmadha NS ◽  
Dr Alla Satyanarayana Reddy ◽  
...  

Author(s):  
R. M. Bala Ashwathy ◽  
N. Deepthi

Background: Acute cerebrovascular disease or stroke is one of the most leading causes of morbidity and mortality. Due to change in dietary habits and life style factors, there is increase in co-morbid conditions like diabetes and hypertension. This in turn increases the risk for developing stroke. Aim: To study the cerebrovascular accident patients by analyzing and comparing their clinical profile. Materials and Methods: A prospective study was conducted in a tertiary care hospital in stroke patients. The type of stroke, associated risk factors and prognosis of the patients were studied. Results: A total of 50 patients were included in the study, for a period of 4 months from January 1, 2021 to April 30, 2021. Both male and female were included in the study. The mean age of the patients was 56.86 years. Thrombotic stroke was the most common (50%) followed by embolic and hemorrhagic stroke. Hypertension was the most commonly associated risk factor (80%), followed by diabetes (60%), smoking (52%), dyslipidemia (34%) and alcohol (28%). The comparatively higher incidence of cerebrovascular accidents in age less than 60 years is attributed to the rise in risk factors in the young age (P<0.05). The average duration of hospitalization was 6.58 days. There is no in-hospital mortality. Conclusion: With prevalence of risk factors on rise, younger individuals are also affected. Proper risk factor management will help in preventing stroke and its recurrence.


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