scholarly journals Ectopic pregnancy at Soavinandriana hospital center, Antananarivo, Madagascar

2018 ◽  
Vol 6 (8) ◽  
pp. 2596
Author(s):  
Romuald Randriamahavonjy ◽  
Hary F. Rabarikoto ◽  
Fy N. A. T. Mahefarisoa ◽  
Tanjona A. Ratsiatosika ◽  
Hery R. Andrianampanalinarivo
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Reproductive Potential ◽  
First Trimester ◽  
Early Presentation ◽  
Induced Abortions ◽  
Life Threatening ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
A Prospective Study

Background: In the first trimester pregnancy, ectopic pregnancy is the most life-threatening gynecological emergency. The aim of this study was to estimate the epidemiological, diagnostic and therapeutic aspects of ectopic pregnancy in Antananarivo, Soavinandriana Hospital Center.Methods: This was a prospective study carried out among consecutive patients of ectopic pregnancy admitted from January 2014 to February 2016. All cases of diagnosed ectopic pregnancy admitted and managed in the gynecological ward were included in the study. These were reviewed and information was extracted regarding women characteristics, clinical features, diagnosis, management and post-operative complications.Results: During this period, there were 41 ectopic pregnancies. The incidence was therefore 20/1000 births. The mean age was 32,26years. The peak age of incidence was the 30-39 years age group. Nulliparous were the most sufferers. The commonest risk factors identified were previous genital infection. (n=17; 41,46%) previous induced abortions (n=15; 36,58%) and the age ≥35 years old (n =16; 39,02%). Twenty seven patients (n=11) did not have a quantitative measurement of the β subunit of human chorionic gonadotropin (β-hCG). Pelvic ultrasound (transabdominal) was performed on all patients. The majority of patients had a laparotomy (n=35, 85,36%). Tubal pregnancies were noted in 90% (n=37) cases.Conclusions: Health educations on early presentation in hospitals are expected to reduce the incidence of EP and the consequent loss of reproductive potential. The majority of risk factors we identified can be early detected and treated.

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.

Heterotopic pregnancy; case report

2019 ◽  
Vol 7 (05) ◽  
Author(s):  
Vipul R. Khandagale
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Adnexal Mass ◽  
Heterotopic Pregnancy ◽  
Free Fluid ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ectopic Pregnancies ◽  
High Index Of Suspicion ◽  
Low Risk Women

Heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. It can be a life threatening condition and easily missed with the diagnosis. We present the case of a 37 year old patient who was treated for a heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.It is difficult to estimate exactly the incidence of ectopic pregnancies, but on an average it is approximately 1:300 normal pregnancies worldwide.

scholarly journals A clinical study of trends of ectopic pregnancy and its management in a tertiary care hospital

2019 ◽  
Vol 8 (12) ◽  
pp. 4834
Author(s):  
Chandana M. Puttaraju ◽  
Nagothi Nagendra Prasad ◽  
M. P. A. Sailakshmi
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Sex Education ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Diagnostic Tools ◽  
Care Hospital ◽  
Care Teaching ◽  
Β Hcg ◽  
Ectopic Pregnancies

Background: Ectopic gestation is a gynaecological emergency which culminates in pregnancy loss and causes significant maternal morbidity, mortality besides jeopardizing future conception. The study discusses the incidence, risk factors, symptomatology and management of ectopic pregnancy in a tertiary care teaching hospital.Methods: This was a prospective study of 45 cases of ectopic pregnancies at a tertiary care teaching hospital from January 2012 to December 2013. Information was collected in a structured proforma, tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 1.17%. Majority of the patients (80%) belonged to 20-30 yrs age group. Second gravidas predominated (42.2%). Fallopian tube was the most common site (95.5%). Rudimentary horn ectopic accounted for 4.65%. Previous abdominopelvic surgery (31.1%), IUCD usage (22.2%), PID (20%), abortions (20%), tubectomy (15.5%) were the principal risk factors. 42% of the patients had no risk factor. The triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 51.1% of cases. Ultrasound, UPT, β-hCG estimation were the diagnostic tools. Ruptured ectopic pregnancy accounted for 64.4%. Nearly 95.5% of patients underwent surgery; salpingectomy (76%). Methotrexate was successful in 4.44%. There was no maternal mortality.Conclusions: Mostly diagnosis, prompt surgical or medical management is cornerstone of treatment. Primary prevention such as improved access to family planning services, sex education, treatment of STI, PID, surgical asepsis  and haemostasis, implementing legislation for dispensing MTP drugs ameliorate risk factors and hence reduce ectopic pregnancy.

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

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.

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 Chronic Tubal Ectopic Pregnancy with Diagnostic Conundrum: A Case Report

2021 ◽  
Vol 6 (2) ◽  
pp. 192-194
Author(s):  
Vishal Sharma ◽  
Ravi Dutt Wadhwa
Keyword(s):  
Case Report ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
First Trimester ◽  
Present Case Report ◽  
Tubal Ectopic Pregnancy ◽  
Threatening Condition ◽  
Life Threatening ◽  
First Trimester Of Pregnancy ◽  
Ectopic Pregnancies

Ectopic pregnancy is a life threatening condition and mostly ectopic pregnancies occurs in fallopian tube. The most common site of ectopic tubal pregnancy is ampulla. Ectopic pregnancy is a complication of pregnancy and usually easy to diagnose by ultrasonography during the first trimester of pregnancy. Due to limited healthcare resources in developing countries, women do not undergo for ultrasound examination during pregnancy which leads to late diagnosis. In most of cases women with ectopic pregnancy are asymptomatic, unless ruptured. The mean gestational age for clinical presentation of ectopic pregnancy is 7.2 weeks after the last normal menstrual period. In rural population, late presentations of ectopic pregnancies are more commonly seen because of lack of modern diagnostic ability. Present case report is a rare case of non-viable, unruptured, tubal ampullary chronic ectopic pregnancy of 12 weeks gestational age. Keywords: Ectopic pregnancy, Unruptured, gestational age, ultrasonography.

scholarly journals LETROZOLE - NOVEL DRUG FOR MEDICAL MANAGEMENT FOR TUBAL ECTOPIC PREGNANCY

2020 ◽  
pp. 1-2
Author(s):  
Rana Choudhary ◽  
Seema Pandey ◽  
Priyanka Vora
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Maternal Morbidity ◽  
First Trimester ◽  
Tubal Ectopic Pregnancy ◽  
Future Fertility ◽  
Life Threatening ◽  
Diagnostic Modalities ◽  
Ectopic Pregnancies ◽  
Novel Drug

Ectopic pregnancy is one of the most common life-threatening conditions leading to increased maternal morbidity and mortality in the first trimester. With advances in diagnostic modalities, one can now diagnose most ectopic pregnancies before their rupture and other catastrophic events. Methotrexate is the most common drug used for medical management but has adverse effects and needs strict monitoring. We report a case of tubal ectopic pregnancy which was successfully managed with letrozole. We were able to prevent maternal morbidity, reduce cost of therapy and preserve future fertility in our patient.

scholarly journals A Case of Cervical Ectopic Pregnancy

2016 ◽  
Vol 27 (1) ◽  
pp. 31-35
Author(s):  
Jahanara Begum ◽  
Shamsun Nahar Begum ◽  
Rowshan Ara ◽  
Shamim Fatema Nargis
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
First Trimester ◽  
Conservative Approach ◽  
Artery Ligation ◽  
Severe Hemorrhage ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ectopic Pregnancies ◽  
Cervical Ectopic Pregnancy

Cervical ectopic pregnancy is the implantation of a pregnancy in the endocervix1. Such pregnancy typically aborts within the first trimester, if it is implanted closer to the uterine cavity called cervico isthmic pregnancy it may continue longer2. Cervical pregnancy accounts for less than 1% of all ectopic pregnancies, with an estimated incidence of one in 2500 to one in 180003-5. Though the pregnancy in this area is uncommon but possibly life threatening condition due to risk of severe hemorrhage and may need hysterectomy. Early detection and conservative approach of treatment limit the morbidity and preserve fertility. A 26 years lady diagnosed as a case of cervical ectopic pregnancy and managed conservatively successfully with adjunctive techniques like cervical artery ligation and cervical temponade to control haemorrhage. The case is reported here for its relative rarity.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(1) : 31-35

scholarly journals Analysis of various types of ectopic pregnancies: a five-year review

2018 ◽  
Vol 7 (6) ◽  
pp. 2410
Author(s):  
Maheswari S. ◽  
Poornima C. ◽  
Lalitha N. ◽  
Seetha Panicker
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
First Trimester ◽  
Reproductive Age ◽  
Morbidity And Mortality ◽  
Pelvic Surgery ◽  
Main Role ◽  
Contraceptive Device ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy (EP) is a common, life threatening emergency during the first trimester and a significant cause for maternal morbidity and mortality. In any woman of reproductive age presenting with abdominal pain and vaginal bleeding, ectopic pregnancy should be considered. The objectives of the present study is to determine the incidence, risk factors, clinical presentation, type of ectopic pregnancy, treatment, morbidity and mortality.Methods: Retrospective analysis of case sheets of patients admitted with ectopic pregnancy at PSGIMSR, Coimbatore during the period July 2011 to June 2016 was done. The details noted were age, parity, risk factors {previous abortion, previous EP, previous pelvic surgery, intrauterine contraceptive device, tubectomy, history of pelvic inflammatory disease}, treatment for infertility, clinical presentation, ultrasound findings, investigations including beta HCG value and hemoglobin level, treatment offered, need for blood transfusion, operative findings and morbidity.Results: During the five year, there were 12,407 deliveries at our hospitals and 88 cases of ectopic pregnancies were managed. The incidence is 6.6/1000 deliveries. Among them 44% belonged to the age group of 25-30 years and multi gravida were 73.8%. Most common risk factors were previous abortion (23.8%) and previous surgeries including caesarean section, tubectomy, appendicectomy, tubal microsurgery (23.8%). Most common presentation was pain abdomen (85.2%). Out of the 88 cases, 73 patients were managed surgically (82.9%) and 11 cases were managed successfully with methotrexate (12.5%). Three of them underwent conservative management and one had Uterine Artery Embolization.Conclusions: Early diagnosis based on risk factors and timely intervention plays a main role in reducing morbidity and mortality associated with ectopic pregnancy.

scholarly journals Abortive Retroperitoneal Ectopic Pregnancy Followed Up by Ultrasound: A Case Report

2020 ◽  
Author(s):  
Tiantian Ye ◽  
Liang Yu ◽  
Yuxin Jiang ◽  
Yu Xia
Keyword(s):  
Ectopic Pregnancy ◽  
Vital Signs ◽  
Uterine Cavity ◽  
Abdominal Ultrasound ◽  
Transvaginal Sonography ◽  
Life Threatening ◽  
Mass Size ◽  
Anechoic Area ◽  
Β Hcg ◽  
Ectopic Pregnancies

Abstract Background: Ectopic pregnancy can be life-threatening. Most of ectopic pregnancy located in the fallopian tube. But retroperitoneal ectopic pregnancies are extremely rare.Results: We report a 29-year-old Chinese woman with amenorrhea for 50 days presented to emergency department for abdominal pain. Her serum β-hCG level was 1675mIU/ml. Transvaginal sonography showed irregular anechoic area in uterine cavity without pregnancy sac echo. And nothing wrong was found in bilateral adnexa. Abdominal ultrasound showed a mixed echo region behind the pancreas. The clinical diagnosis was retroperitoneal ectopic pregnancy. The patient's vital signs remained stable with the mass size continue decreased . Because of the huge surgery risk, the mass was followed up by ultrasound closely.Conclusions: 5 months after bleeding, the fourth ultrasound follow-up examination showed the mass disappeared completely and serum β-hCG level was normal .

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