A clinical study on ectopic pregnancy in tertiary care hospital Imphal

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.

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

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v13i3.20993 ◽

2014 ◽

Vol 13 (3) ◽

pp. 1-4 ◽

Cited By ~ 2

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

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Ectopic pregnancy: an observational study in a tertiary care centre of Southern Rajasthan, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200062 ◽

2020 ◽

Vol 9 (2) ◽

pp. 516

Author(s):

Shrusti Parmar ◽

Nalini Sharma ◽

Vimla Dhakar

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Care ◽

First Trimester ◽

Treatment Modalities ◽

Public Health Issue ◽

Care Centre ◽

Tertiary Care Centre ◽

Cross Sectional ◽

Early Presentation

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.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20190307 ◽

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.

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A clinical study of ectopic pregnancy in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184489 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4461

Author(s):

Arati Behera ◽

Ranjita Ghadei ◽

Rudra Narayan Bal

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Care ◽

Medical Practitioner ◽

High Risk Group ◽

Reproductive Age ◽

Common Symptom ◽

Care Hospital ◽

Age Group ◽

Future Fertility

Background: Ectopic pregnancy is a life-threatening emergency commonly encountered by medical practitioner. Diagnosis is frequently missed and should be considered in any women in the reproductive age group with abdominal pain or vaginal bleeding. The aim of the study is to assess the incidence, clinical presentation, risk factors, methods of diagnosis, treatment, outcome and complications.Methods: This was a prospective study at S.C.B. Medical college from January to December 2017. Parameters like age, parity, gestational period, risk factors, clinical presentations, findings on ultrasonogram and at surgery with morbidities associated with diagnosed cases of ectopic pregnancy (n=93) were noted and analysed with SPSS-19 software.Results: Incidence of ectopic pregnancy was 18/1000 deliveries. Maximum cases were in age group of 21 to 30 years (54.8 %) and parous (76.3%). Common risk factors were having history of abortions (46.2%), previous tubal sterilization (24.7%), having one or more caesarean section (17.2%) and h/o infertility (16.1%). Most common symptom was pain abdomen (96.8%). Commonest site was ampullo-isthmic region of tube and rupture was the commonest mode of presentation. All underwent laparotomy and unilateral salpingectomy was done in 86 % of cases. It contributed to 3.27 % of total maternal deaths.Conclusions: Suspicion in high risk group can direct one to investigate and diagnose early, thereby reducing morbidity, mortality and improving the prospect of future fertility.

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An analysis of tubal ectopic pregnancy in a rural tertiary care hospital in India: a retrospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193636 ◽

2019 ◽

Vol 8 (9) ◽

pp. 3466

Author(s):

Chandana Galidevara ◽

Swaramya C.

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Care ◽

Care Hospital ◽

Common Procedure ◽

Tubal Ectopic Pregnancy ◽

Retrospective Data Analysis ◽

History Of ◽

Wound Discharge ◽

Ectopic Pregnancies

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.

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Risk factors for ectopic pregnancy; an institutional study in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20195312 ◽

2019 ◽

Vol 8 (12) ◽

pp. 4741

Author(s):

Ranjita Ghadei ◽

Swayamsiddha Mohanty ◽

Sushree Sovana Mishra ◽

Debashis Giri

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Care ◽

Previous History ◽

Diagnostic Tools ◽

P Value ◽

Care Hospital ◽

Pregnancy Risk ◽

History Of ◽

A Prospective Study

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.

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FREQUENCY OF UNRUPTURED ECTOPIC PREGNANCY IN A TERTIARY CARE HOSPITAL OF HAIL CITY, SAUDI ARABIA

Annals of King Edward Medical University ◽

10.21649/akemu.v21i4.764 ◽

2016 ◽

Vol 21 (4) ◽

pp. 236

Author(s):

Saadia Rasheed ◽

Sehar Shahbaz ◽

Shazia Hammad

Keyword(s):

Ectopic Pregnancy ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Lower Abdominal Pain ◽

First Trimester ◽

Transvaginal Sonography ◽

Care Hospital ◽

Positive Urine ◽

History Of ◽

Urine Pregnancy Test

AbstractAims and Objectives:Determine the frequency of unruptured ectopic pregnancy in a tertiary care hospital of Hail City, Saudi Arabia.Study Design:It was an observational case series.Material and Method:A total of 150 cases between 15 44 years with history of amenorrhea (6 8 weeks) and vaginal bleeding with or without lower abdominal pain, positive urine pregnancy test were enrolled in the study while heterotopic pregnancy, ruptured ectopic pregnancy and patients in first trimester with obstetric problem other than ectopic pregnancy were excluded from the study. All these cases were collected from Maternity and Childrens hospital Hail, Kingdom of Saudia Arabia during 2011 to 2014.Results:In our study, 64.67% (n = 97) of the cases were between 15 30 years of age while 35.33% (n = 53) were between 31 44 years, mean sd was calculated as 26.34 2.67 years, frequency of unruptured ectopic pregnancy was recorded in 14% of the cases.Conclusion:The frequency of un-ruptured ectopic pregnancy is higher and TVS may be used for early detection of this morbidity.Key Words:Ectopic pregnancy, un-ruptured, Transvaginal sonography.

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A clinical study of ectopic pregnancy at a tertiary care centre in Telangana, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20200358 ◽

2020 ◽

Vol 9 (2) ◽

pp. 682

Author(s):

Subha Ranjan Samantaray ◽

Ipsita Mohapatra ◽

Achanta Vivekanada

Keyword(s):

Risk Factors ◽

Early Diagnosis ◽

Ectopic Pregnancy ◽

Vaginal Bleeding ◽

Clinical Presentation ◽

Tertiary Care ◽

High Morbidity ◽

Tertiary Care Centre ◽

Life Threatening ◽

History Of

Background: Ectopic pregnancy (EP) is a life-threatening obstetrics emergency in early trimester, associated with a high morbidity and mortality if not timely intervened. High index of clinical suspicion is required for early diagnosis, specifically in women presenting with amenorrhoea, pain abdomen and vaginal bleeding. Aim of this study is to determine the incidence, risk factors, clinical presentation, management and outcome of ectopic pregnancy.Methods: This retrospective observational study was conducted in the department of obstetrics and gynaecology, at Prathima institute of medical sciences, Telangana from July 2012 to June 2019, for a period of 7 years. A total of 53 cases of ectopic pregnancy were analyzed for parameters like age, gravidity, gestational age, risk factors, clinical presentation, management and morbidity.Results: Incidence of ectopic pregnancy was 5.3 per thousand deliveries. Majority of cases were in age group of 20 to 25 years (52.8%) and were gravida 3 and above (68%). The commonest risk factors identified were history of previous pelvic surgeries (37.7%) followed by history of abortion (18.8%). Commonest symptoms were abdominal pain (90.6%), amenorrhoea (75.5%) and vaginal bleeding (47.2%). Only 41.5 % of cases had triad of symptoms. Fallopian tube (92.4%), specifically ampulla (62.3%) was the most frequent site affected. About 73.6% cases presented with ruptured tube. Surgery (94.3%) was the mainstay of therapy.Conclusions: ectopic pregnancy is a life-threatening emergency, early diagnosis and treatment will improve the prognosis.

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Risk factors of ectopic pregnancy: a study in a tertiary care centre

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20172589 ◽

2017 ◽

Vol 6 (7) ◽

pp. 2858 ◽

Cited By ~ 1

Author(s):

Beera Neelima ◽

V. G. Vanamala

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Tertiary Care ◽

First Trimester ◽

Age Group ◽

Tertiary Care Centre ◽

Induced Abortions ◽

First Trimester Of Pregnancy ◽

The Mean ◽

Timely Treatment

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.

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Prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182713 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1057

Author(s):

Edakkattil Rameshkumar ◽

Salini Ajitha

Keyword(s):

Pseudomonas Aeruginosa ◽

Otitis Externa ◽

Clinical Presentation ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Causative Organism ◽

Care Hospital ◽

Age Group ◽

History Of ◽

The Common

Background: Otitis externa, an inflammatory condition commonly reported in almost all age groups. But the prevalence and etiology are varying on different region. This study was aimed to find out the prevalence of self probing, clinical presentation and the causative organism among the patients presented with otitis externa in a tertiary care hospital.Methods: All the patients presented with otitis externa in the outpatient department of ENT were included in the retrospective study. The history of self probing was identified using a questionnaire. The clinical presentation was noticed and organism was isolated from the swab taken from the external ear canal. The non-parametric data was expressed in numbers and percentage. Results: Total 49 patients were included in the study. The average age of patient was 39.5±14.3 years with 24 males and remaining females. Among them, 85.7% (42/49) had a history of self probing (p<0.05). The most prevalent age group for the self probing associated otitis externa was 31 to 40 years. The discharge was the major clinical presentation (40/49) and the common organism isolated was Pseudomonas aeruginosa in 38% of incidence.Conclusions: Self probing was major etiological factor for otitis externa in the age group of 31-40 years. Discharge was the major clinical presentation and the common organism isolated was Pseudomonas aeruginosa. This emphasized the need for a proper awareness programme in the society against self probing to reduce the incidence.

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