scholarly journals A retrospective study of ectopic pregnancy

Author(s):  
A. Shameera Banu ◽  
N. R. Indu ◽  
E. Rohini ◽  
Hiremath P. B. ◽  
Reshma Hiremath

Background: Ectopic pregnancy is one of the common acute abdominal emergencies posing a serious threat to life. The overall incidence of ectopic pregnancy is on a steady increase over the last two decades. Yet the case fatality rate has come down due to early diagnosis and management. 95% of ectopic pregnancies occur in the fallopian tube, and rest 5% cumulatively in the ovary, cervix, peritoneal cavity and previous caesarean section scar. The present study was done to analyse the associated risk factors, clinical manifestations and management options of ectopic pregnancy.Methods: This retrospective observational cohort study was done in the Department of Obstetrics and Gynaecology, at Sri Venkateshwaraa Medical College, Hospital and Research Centre, Ariyur, Puducherry, between January 2018- November 2021. Data was collected from the case sheets, operative notes and a retrospective analysis of the cohort of patients with ectopic pregnancy was done.Results: This retrospective study was conducted from January 2018 to November 2021 involving a total of 50 cases. We found that majority of tubal gestation occurred in the age group 26-30 years 58.6% and 13.7% in the age group more than 30 years. Majority of patients 65.5% underwent U/L salpingectomy.10.34% underwent salpingo oophorectomy. Fimbrial expression was done for two patients. Two patients underwent fimbriectomy. Cornual stump excision was done in two patients. Hemoperitoneum was detected in 55.17% of cases.Conclusion: Ectopic gestation can become an obstetrical emergency and reproductive capacity hampering morbidity if not diagnosed and treated on time. However having a high vigilance and evaluating every woman in the reproductive age group who presents with the classical clinical triad of amenorrhea, pain abdomen and bleeding per vagina can help in curbing the incidence in future. 

2020 ◽  
pp. 80-82
Author(s):  
Shweta Shah ◽  
S.K. Suri ◽  
Ami Shah

Background: Most frequently performed gynaecological surgery is hysterectomy. The prevalence of hysterectomy varies within different regions. There are mainly two types of hysterectomies according to which part of uterus is removed. The main types of hysterectomy are total and subtotal or partial hysterectomy. The hysterectomy can be performed by three routes abdominal, laproscopic and vaginal hysterectomy. The main objective of our study is to know most common pathology and different age groups of the patients underwent hysterectomy. Materials and Methods: In this retrospective study was carried during period 6 months, at GCS medical college, hospital and research centre, Ahmedabad. Total 100 hysterectomy specimens were analyzed for histopathological lesions. We had taken the clinical and histopathological findings of these cases from the records of department of pathology, GCS medical college , hospital and research centre. Results: In our study of 100 cases, most common age group underwent hysterectomy was 40-49 years and least common age group was 20-29 years. Type of hysterectomy performed most commonly in this study was total abdominal hysterectomy with bilateral salpingoophorectomy. Most of lesions were seen in the myometrium 42 cases (42%), Endometrium 32 cases (32%), Cervix 16 cases (16%) and Ovary 10 cases (10%). Hysterectomy remains the widely used treatment modality.


2021 ◽  
Author(s):  
Andargie Abate ◽  
Lemu Golassa

Abstract Introduction: Malaria continues to strike hardest against the public health and economic development in Ethiopia. Its transmission tends to be highly heterogeneous within or between years, and from area to area which need understanding of the contextual diversity of malaria prevalence within each site to deliver optimal intervention according to the site specific situation of the disease. Thus, this study was aimed to determine the trend prevalence of malaria in Mojo health center, East Shoa Zone, Ethiopia. Methods: A retrospective study was conducted in Mojo health center, East Shoa zone, Ethiopia from February to March, 2021. Malaria cases and related data reported 2016-2020 were carefully reviewed from laboratory registration logbooks. The collected data was analyzed using SPSS 25 software.Results: A total of 19, 106 blood films were examined from malaria suspected patients. The overall microscopically confirmed prevalence of malaria was 4.2%. P. vivax was the predominant species accounting 76.2% of positive samples. Malaria cases declined from 259 in 2016 to 77 in 2020. The proportion of malaria was higher among males (64.8%) than females (35.2%) in all five years. Higher malaria cases was observed from the age group 15-24 years old followed by the age group of 25-34. Malaria cases were at a peak level from September-November and lowest from December-February.Conclusion: Although the declining trend of malaria prevalence was observed, malaria still remains a public health burden in the area. The high burden of malaria among reproductive age group, males, and during cultivation season reflects its impact on health and economic development. Shifting of P. falciparum to P.vivax related malaria should get an attention during prevention and control strategies for the successful progress of malaria elimination programme.


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.


2013 ◽  
Vol 6 ◽  
pp. CCRep.S13527
Author(s):  
Monika Rathi ◽  
Rehana Najam ◽  
Satish Kumar Budania ◽  
Seema Awasthi ◽  
Faiyaz Ahmad ◽  
...  

We present a case of a 22-year-old female who presented with acute abdomen and amenorrhea. Emergency laprotomy was done with a clinical diagnosis of ectopic pregnancy. On laprotomy, twisted fimbrial cysts were found. Thus, although fimbrial cysts are rarely twisted, they should be considered as a cause of acute abdomen in a female of reproductive age group.


Author(s):  
Mamata Soren ◽  
Ranjita Patnaik ◽  
Bismoy Kumar Sarangi

Background: Ruptured ectopic pregnancy is a medical emergency; therefore, it is imperative to diagnose the unruptured ectopic pregnancy such that timely intervention will prevent morbidity and mortality Today with availability of monoclonal β-HCG, high resolution transvaginal scan and laparoscopy it is possible to make early diagnosis even before rupture.Methods: Prospective study of two years duration with sample of 72 cases of suspected ectopic pregnancy observed and treated out of total 20193 pregnant women admitted were included in this study.Results: The incidence was 0.36%, maximum between the age group of 26-30 years (33.3%). Risk factors were tubectomy (30.56%), D and C (6.94%), PID (5.6%), previous ectopic (1.39%), IUCD (2.78%). The typical triad of amenorrhoea, pain abdomen and bleeding was observed in 54.2% of cases. 19 patients were brought in shock (26.4%). Ultrasonography done in 56 cases.Conclusions: There is an increase in the incidence of ectopic pregnancy but a decrease in maternal mortality during the past two decades. Although the early diagnostic tools were available, we had to manage most of our patients as surgical emergencies, as they were brought late in the trial, with established diagnosis of ruptured ectopic pregnancy. Physicians should be sensitive to the fact that in the reproductive age group any women presenting with pain in the lower abdomen, diagnosis of ectopic pregnancy should be entertained irrespective of the presence or absence of amenorrhoea, whether or not she has undergone sterilization. 


e-CliniC ◽  
2015 ◽  
Vol 3 (3) ◽  
Author(s):  
Aljufri Syamsudin ◽  
Marlyn G. Kapantow ◽  
Renate T. Kandou

Abstract: Candidiasis vulvovaginalis (candida vulvovaginitis) is an infection of the vagina or vulva by Candida genus, with a variety of clinical manifestations that can occur acutely, chronically, or episodically. This study aimed to determine the profile of candidiasis vuvovaginalis in the Dermatology clinic Prof. Dr. R. D. Kandou Manado during the period of January to December 2012. This was a retrospective study using the medical records of new patients with a diagnosis of candidiasis vulvovaginalis. The results showed that there were 30 patients (2.73%) with candidiasis vulvovaginalis among 1096 new patients. It was more commonly found in women with the largest age group 25-44 years, residence in Manado, and as housewives, The most frequent therapy was systemic antifungals and antihistamine. The occurence of this disease was associated with other diseases such as bacterial vaginosis.Keywords: vulvovaginaliscandidosis, candida albicansAbstrak: Kandidiasis vulvovaginalis (kandidosis vulvovaginalis, kandida vulvovaginitis) adalah infeksi vagina dan atau vulva oleh Genus Candida, dengan berbagai manifestasi klinisnya yang bisa berlangsung akut, kronis atau episodik. Penelitian ini bertujuan untuk mengetahui profil kandidiasis vuvovaginalis di poliklinik Kulit dan Kelamin RSUP Prof. Dr. R. D. Kandou Manado periode Januari – Desember 2012. Penelitian ini dilakukan secara retrospektif dari rekam medik pasien baru dengan diagnosis kandidiasis vulvovaginalis. Hasil penelitian menunjukkan bahwa terdapat 30 pasien (2,73%) kandidiasis vulvovaginalis dari 1.096 pasien baru, lebih banyak ditemukan pada perempuan dengan kelompok umur 25-44 tahun, didapatkan bahwa wilayah tempat tinggal terbanyak adalah Kota Manado, menurut pekerjaan paling banyak terjadi pada IRT (Ibu rumah tangga), terapi yang banyak digunakan adalah Antijamur sistemik+antihistamin, dan kombinasi kandidiasis vulvovaginalis dengan penyakit lain terbanyak yaitu kandidiasis vulvovaginalis + bakterial vaginosis.Kata kunci: kandidiasis vulvovaginalis, candida albican, penelitian retrospektif


Author(s):  
Anuradha D. Murki ◽  
Vasundhara Kamineni ◽  
Sowmya R. Velagapudi ◽  
Ashok K. Deshpande

Background: Women with adnexal masses can present with acute symptoms such as abdominal pain, nausea and vomiting. As there is insufficient evidence on the frequency, presentation and management of adnexal masses we conducted this study to evaluate the clinical profile, surgical findings and histopathology of adnexal masses in women presenting with acute abdomen and needing surgical intervention.Methods: In this prospective observational study, history, examination, investigations and ultrasound of abdomen and pelvis were evaluated in women presenting with acute abdomen with adnexal mass and needing surgical intervention. Diagnosis was confirmed from the operative findings and histopathology. Etiology and its correlation with clinical symptoms and signs and radiological diagnosis formed the primary objective of the study.Results: Of the 79 patients enrolled in the study, the mean age was 30.82±6.69 years. Younger women were likely to have ectopic pregnancy while older women (>35 years) other tubal pathologies. Pain abdomen (n=70) and nausea (n=53), bleeding per vagina(n=33), menstrual irregularities (n=18), fever (n=10) abdominal distension (n=10) and dysuria (4) were the common symptoms. Etiology of the adnexal mass was ectopic pregnancy (57%), ovarian mass (34%), tubal mass (7.5%), tube and ovary (2.5%) in 46, 25, 6 and 2 patients respectively. 61% (n=48) of the women underwent laparoscopic management. Women with ruptured ectopic pregnancy were more likely to have abdominal distension, pallor, hypotension, cervical motion tenderness and need for blood transfusions.Conclusions: In women from reproductive age group with adnexal mass and needing surgery, ectopic pregnancies and benign ovarian tumours were the common etiologies. Urine pregnancy test and ultrasound are useful tests to differentiate ectopic from ovarian and tubal pathology.


Author(s):  
Arati Behera ◽  
Ranjita Ghadei ◽  
Rudra Narayan Bal

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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