scholarly journals Clinical presentation and outcome of ectopic pregnancy

2021 ◽  
Author(s):  
Mohammed Sidhiq Chundakkadan ◽  
Chandramathy K. ◽  
Neethu Selvest
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Excellent Result ◽  
Clinical Manifestations ◽  
Uterine Cavity ◽  
Antenatal Visit ◽  
Medical College ◽  
History Of ◽  
Selection Of

Background: An ectopic pregnancy is defined as blastomere implants anywhere other than the endometrial lining of the uterine cavity. The incidence was around 1-1.5%. Commonest site in fallopian tube (95%). Even the incidence was small, it accounted for 3% of the pregnancy related deaths. The objective of this study was to evaluate the clinical presentation of various types of ectopic pregnancy, any risk factors, various types of management and the outcome.Methods: This was a prospective COHORT study of 102 ectopic patients admitted at government medical college, Kozhikode during 18 November 2020 to 17 August 2021 with various clinical manifestations. Depends on clinical features, USG findings and HCG estimation, patients were treated by expectant, medical and surgical management. Patients followed up for 2 weeks after discharge.Results: 102 cases were admitted in study period. 98 cases were tubal ectopic. 69.6% with history of various risk factors. Commonest age group was 26-35 years. 70.6% were multiparous. HCG <5000 responded very well to medical management (92.8% success rate).Conclusions: Most common ectopic pregnancy is tubal ectopic and commonly associated with various risk factors. Triad of symptoms will be present in most cases. Early antenatal visit will reduce the number of ruptured ectopic. Careful selection of cases by HCG value and size of ectopic will give excellent result.

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 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  

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 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 Clinical Outcome and Operative Findings with Ectopic Pregnancy at Tertiary Medical College & Hospital

2021 ◽  
Vol 33 (2) ◽  
pp. 160-164
Author(s):  
Fahmida Sultana ◽  
Gulshan Ara ◽  
Sayma Afroz ◽  
Rokshana Parvin Nupur ◽  
Mashah Binte Amin
Keyword(s):  
Clinical Outcome ◽  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Clinical History ◽  
College Hospital ◽  
Medical College ◽  
History Of ◽  
Common Operation ◽  
Medicine Today ◽  
Operative Findings

Introduction: An ectopic pregnancy is an emergency condition worldwide now a days which defined as a pregnancy that progresses after implantation of the blastocyst anywhere other than the endometrium lining the uterine cavity. Objective: In this study our main goal is to identify clinical outcome and operative situation in patients. Materials and Methods: This descriptive study was performed from January 2015 to December, 2018 at tertiary medical College & Hospital. During the study 200 patients were evaluated and data was extracted from socio-demographic, menstrual, obstetric and clinical history of the patients. Results: most of the patients belong to 30 years (19.7%) age group and history of pelvic infection (26.26%), induced abortion (17.4%), previous MR (16.26%) and sub fertility (11.25%) were common risk factor in ectopic pregnancy found in the study. Also majority of the patients faced laparotomy followed by right sided salphinogectomy (40.40%) which was the most common operation. Conclusion: quick diagnosis, classifying of risk factors and timely intervention in the form of surgical treatment is necessary for reduction mortality rate in ectopic pregnancy. Medicine Today 2021 Vol.33(2): 160-164

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

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.

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 A clinical study on ectopic pregnancy in tertiary care hospital Imphal

2021 ◽  
Vol 10 (2) ◽  
pp. 562
Author(s):  
Naorem Sunanda Chanu ◽  
Vinodkumar Suresh Basavaradder ◽  
Cibi Darsani ◽  
Ahanthembi Sanaton
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
First Trimester ◽  
Treatment Modalities ◽  
Care Hospital ◽  
Grey Zone ◽  
Age Group ◽  
History Of

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.

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

The physiopathology of spontaneous hemorrhagic stroke: a systematic review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Alcivan Batista de Morais Filho ◽  
Thiago Luis de Holanda Rego ◽  
Letícia de Lima Mendonça ◽  
Sulyanne Saraiva de Almeida ◽  
Mariana Lima da Nóbrega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Natural History ◽  
Hemorrhagic Stroke ◽  
Recent Literature ◽  
Clinical Manifestations ◽  
The Road ◽  
History Of

Abstract Hemorrhagic stroke (HS) is a major cause of death and disability worldwide, despite being less common, it presents more aggressively and leads to more severe sequelae than ischemic stroke. There are two types of HS: Intracerebral Hemorrhage (ICH) and Subarachnoid Hemorrhage (SAH), differing not only in the site of bleeding, but also in the mechanisms responsible for acute and subacute symptoms. This is a systematic review of databases in search of works of the last five years relating to the comprehension of both kinds of HS. Sixty two articles composed the direct findings of the recent literature and were further characterized to construct the pathophysiology in the order of events. The road to the understanding of the spontaneous HS pathophysiology is far from complete. Our findings show specific and individual results relating to the natural history of the disease of ICH and SAH, presenting common and different risk factors, distinct and similar clinical manifestations at onset or later days to weeks, and possible complications for both.

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