scholarly journals Risk factors, clinical presentation and management of ectopic pregnancy in a rural tertiary care centre- An observational study

2021 ◽  
Vol 8 (3) ◽  
pp. 296-300
Author(s):  
Lopamudra B John ◽  
Lingampalli Naga Saketha ◽  
Setu Rathod
Keyword(s):  
Risk Factors ◽  
Observational Study ◽  
Ectopic Pregnancy ◽  
Teaching Hospital ◽  
Surgical Intervention ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Teaching Hospital ◽  
History Of ◽  
Ectopic Pregnancies

: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the risk factors, clinical features at presentation, diagnostic tools, management modalities and outcome of ectopic pregnancies in a tertiary care teaching hospital.: This was an observational study of 90 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from February 2019 to August 2020. Relevant data of the 90 patients was tabulated and descriptive analysis was done. : Chi square and Fischer exact test: Majority of the patients belonged to 21-30 yrs age group. Maximum number of cases (57%) had a history of previous abdomino pelvic surgery. The predominant symptom was amenorrhea (96.6%) and classical triad of amenorrhea, bleeding per vagina and abdominal pain was seen in 30% of the study population. Majority of the patients i.e 76.7% underwent surgical intervention.: Most common age group at presentation is 21-30years. History of previous abdominal surgery being the most important risk factor whereas amenorrhea was the most common symptom. Surgical intervention was the main mode of management in ruptured ectopic pregnancy.

scholarly journals A study of incidence, risk factors, clinical profile and management of 50 cases of ectopic pregnancy in a tertiary care teaching hospital

2017 ◽  
Vol 6 (4) ◽  
pp. 1336 ◽  
Author(s):  
G. Ganitha ◽  
G. Anuradha
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Teaching Hospital ◽  
Maternal Morbidity ◽  
Tertiary Care ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Maternal Morbidity And Mortality ◽  
Incidence Risk ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies in a tertiary care teaching hospital.Methods: This was a prospective study of 50 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from August 2012 to September 2013. Relevant data of the 50 patients was tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 6.3 per 1000 deliveries. Majority of the patients (82%) belonged to 20-30 yrs age group. 70% of the women were multiparous. The commonest site of ectopic pregnancy was fallopian tube (92 %). Past history of pelvic inflammatory disease (40%), abortions (20%), abdominopelvic surgery (14%) and IUCD usage (12%) were among the important risk factors identified. 20% of the patients had no identifiable risk factor. The classical triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 56 % of the study population. The most important signs which guided the diagnosis of ectopic pregnancy were cervical excitation pain (74%), abdominal tenderness (72%), adnexal mass or fullness (68%) and tenderness in the fornix (68%). Clinical presentation, urinary pregnancy test, culdocentesis and ultrasound were the diagnostic tools used for diagnosis of ectopic pregnancy. The incidence of ruptured ectopic pregnancy was 86%. Majority of the patients underwent salpingectomy (96%). There was no maternal mortality in our study.Conclusions: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.

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

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.

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 Clinicosociodemographic profile of ruptured ectopic pregnancies at a tertiary care centre

2017 ◽  
Vol 6 (5) ◽  
pp. 1885
Author(s):  
Soumya Ranjan Panda ◽  
Anjali Rani ◽  
Mahendra Meena
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Factors Associated ◽  
Number Of Patients ◽  
History Of ◽  
Ectopic Pregnancies

Background: Rupture of an ectopic pregnancy remains the most dreaded complication of a pregnancy related event and is the commonest cause of maternal mortality in the first trimester of pregnancy. In the developing countries, the maternal death rate among patients admitted with ectopic pregnancy was found to be as high as one in ten. In addition to high risk for mortality, rupture of an ectopic pregnancy could affect future fertility of a woman. The objectives of this study are to analyse the sociodemographic and clinical characteristics and find out the incidence rate and risk factors associated with ruptured ectopic pregnancies in a tertiary care institution.Methods: This is a retrospective study and was conducted over a period of one year from September 2015 to September 2016 in Department of Obstetrics and Gynecology at Institute of Medical Sciences, BHU, Varanasi, India. It is a tertiary care centre getting referrals not only from nearby cities and hospitals but also from major cities of neighbour states. During this time frame a total of 2601 deliveries have taken place and 57 cases of ruptured ectopic pregnancies were reported. Data were collected in a preconceived format.Results: Total numbers of vaginal deliveries were 2601 during the study period. Out of which 63 (2.42%) were found to be ectopic pregnancies and 57 (1.99%) were diagnosed as ruptured ectopic pregnancies. Maximum number of patients (70.17%) were between 21 and 30 years of age. As far as parity is concerned only 12.29 % of patients were primigravida where as 70.71% patients were multigravida. Previous history of pelvic inflammatory disease was associated among maximum number of cases i.e 50.87% of total number of cases. Among other risk factors, previous abortions, previous ectopic pregnancies and history of infertility treatment were the prime ones. Maximum number of patients were from lower and lower middle class socioeconomic status. Ampullary type of Tubal ectopic pregnancies were found to be the commonest ones. Two cornual pregnancies and two ovarian pregnancies were also found in this series. In 85.97 % of patients the amount of hemoperitoneum was found to be more than 500 ml.Conclusions: There is high incidence rate of ectopic pregnancy and low rate of diagnosis before rupture occurs in developing nations as in our scenario. Pelvic inflammatory disease, Maternal education, socioeconomic status, parity and history of subfertilty are the risk factors associated with ruptured ectopic pregnancy. Effective efforts should be taken to encourage the level of education and improve the rate of diagnosis among health care providers before the occurrence of rupture.

scholarly journals A clinical study of ectopic pregnancy in a tertiary care centre in Hubli

2017 ◽  
Vol 6 (4) ◽  
pp. 1566
Author(s):  
Swetha Dama ◽  
Amitha Kamat
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
First Trimester ◽  
Tubal Sterilization ◽  
Tertiary Care Centre ◽  
History Of ◽  
Ectopic Pregnancies ◽  
One Year ◽  
High Degree

Background: To evaluate the burden of ectopic pregnancies in our hospital over the period of one year and to evaluate the risk factors, mode of intervention and outcomes of those cases.Methods: A retrospective analysis was conducted in Karnataka Institute of Medical Sciences, Hubli over the period of one year from January 2015 to December 2015. All patients admitted with a diagnosis of ectopic pregnancy, either ruptured or unruptured were included in the study. Their history, risk factors, outcome and complications were also evaluated in detail.Results: 40 patients with diagnosis of ectopic pregnancy were admitted, yielding to an incidence of 3.76/1000. Most patients presented to our hospital in a state of shock. 26(65%) were ruptured, 10(25%) were unruptured and 4(10%) were chronic ectopic pregnancies. 39 cases were managed by laparotomy and one patient by conservative method using methotrexate. Most common risk factor noted in our study was history of tubal sterilization, noted among 12(30%) women. No mortality was noted in our study.Conclusions: Ectopic pregnancy is a significant cause of morbidity and mortality in first trimester. High degree of suspicion and early detection can prevent a great degree of morbidity among women, especially in women with prior tubal sterilization procedure.

scholarly journals Prevalence and the risk factors for the carriage of beta-haemolytic streptococci among women visiting a tertiary care hospital in South India

2021 ◽  
Vol 8 (4) ◽  
pp. 308-312
Author(s):  
Pendru Raghunath ◽  
LN Rao Sadanand
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Latex Agglutination ◽  
Research Centre ◽  
Care Hospital ◽  
Microbiological Techniques ◽  
History Of ◽  
Group B

Streptococci are gram positive cocci arranged in chains and are part of normal flora of humans and animals. The present study is carried out to determine the prevalence and risk factors for the carriage of beta-haemolytic streptococci (BHS) among women visiting Dr. VRK Women’s Teaching Hospital & Research Centre, Hyderabad. Vaginal swabs were collected from 250 patients attending outpatient department (OPD) of Dr. VRK Women’s Teaching hospital. Swabs were inoculated onto 5% sheep blood agar plates and incubated for 24 h at 37°C in a candle jar. BHS isolates were phenotypically identified by standard microbiological techniques, all the isolates presumptively identified as BHS were tested for Bacitracin susceptibility. Sensitive isolates were presumptively identified as GAS and resistant isolates were identified as non-group A BHS (NGABHS). Presumptively identified GAS & NGABHS isolates were serogrouped by Lancefield grouping using a commercially available latex agglutination test. BHS were isolated from 12.4% of samples. As many as 12 BHS isolates were identified as GAS and 19 were identified as NGABHS. Ten of nineteen were identified as group B (GBS), 4 (12.9%) were identified as group C (GCS) and 5 (16.12%) were identified as group G (GGS). Among six clinical groups, the prevalence of GAS is highest i.e. 7.5% in female patients visiting Gynaecology OPD with history of white discharge. Prevalence of NGABHS was more among post insertion (18%) IUCD group compared to pre insertion (8%) IUCD group. GBS were isolated from 7% of samples from IUCD group and 4% of samples from prostitutes.This study reports the prevalence of BHS among women visiting a tertiary care hospital in Hyderabad. This study also identified certain risk factors such as IUCD usage and working as a FSW are associated with the increased prevalence of NGABHS especially GBS.

scholarly journals Study on Risk Factors, Clinical Presentation & Operative Management of Ectopic Pregnancy

2016 ◽  
Vol 28 (1) ◽  
pp. 9-14
Author(s):  
Kamrun Nahar ◽  
Turani Talukder ◽  
Sabiha Sultana ◽  
Md Anwar Hossain
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Operative Management ◽  
Age Group ◽  
Presenting Symptoms ◽  
Patient Profile ◽  
Short Period ◽  
History Of ◽  
Acute Condition

Introduction: Ectopic pregnancy is a major clinical problem in gynaecology because it is often difficult to diagnose as the patient present in different ways. An accurate history taking and physical examination is considered to be most important in the diagnosis of ectopic pregnancy. There are two treatment options, medical or surgical. Surgical treatment is the fastest treatment for ectopic pregnancy though surgical management decreased from approximately 90% to 65%1. Surgery may be the only treatment option if there is internal bleeding. In the medical treatment group, 15% of cases were categorized as failures and required surgery1.Objectives: This study was conducted in the department of obst and Gynae of Dhaka Medical College Hospital from January 2005 to June 2005 in an attempt to find out the risk factors of ectopic pregnancy, the way of presentation and to analyze the operative treatment of ectopic pregnancy.Materials and Methods: A total 50 consecutive patients who were clinically suspicious of ectopic pregnancy were included in this study between January 2005 to June 2005. Patients who were clinically suspicious of EP and also supported by positive urinary pregnancy tests, beta hCG and no intrauterine gestational sac in ultrasonography were included in this study. Detailed discussion about the study was done with the patient and then informed verbal consent was taken from them. Detailed history about patient profile, presenting symptoms, any risk factors and clinical examination done and the findings were recorded in the predesigned data collection sheet. Data was expressed in terms of frequencies and percentagesResults: Most of the patients were in the age group of 20-30 years and 38% of low parity (para- 1).Previous miscarriage, infertility,IUCD users and PID identified as the risk factors of ectopic pregnancy— 42% patients had history of previous abortion or MR, period of infertility 22%, pelvic infection 12%, IUCD users 16%. In this study acute abdominal pain after a short period of amenorrhoea was found to be the main symptoms in ectopic pregnancy—100% patients were presented with lower abdominal pain, 70% with period of amenorrhea and 50% patients with per vaginal bleeding. All the patients were presented with acute condition and were surgically managed fastest treatment. At the time of operation 84% of ectopic tubal pregnancy were found ruptured, 10% were tubal abortion and 4% unruptured. Sites of ectopic pregnancy were ampullary 50%, isthmic 20%, fimbrial 10%.Conclusion: Most of the patient presented in acute condition with the classical features of ruptured ectopic pregnancy. Near half of the patient were in younger age group (26 – 30 years) having risk factors like history of previous abortion/MR 42%, infertility 22% use of IUCD 16%, PID 12%. More then three forth( 84%) of cases were diagnosed as ruptured ectopic during operation. Operative management was done on the basis of site of ectopic and parity of the womanBangladesh J Obstet Gynaecol, 2013; Vol. 28(1) : 9-14

An Epidemiological Assessment of Endometrial Carcinoma Including Demographics and Histopathological Correlation, from a Tertiary Care Teaching Hospital in South India

2021 ◽  
Vol 8 (30) ◽  
pp. 2751-2756
Author(s):  
Jeenu Babu ◽  
Reeba George Pulinilkunnathil ◽  
Bindu R. Kumar
Keyword(s):  
Risk Factors ◽  
Endometrial Carcinoma ◽  
Teaching Hospital ◽  
South India ◽  
Tertiary Care ◽  
Endometrial Biopsy ◽  
Prognostic Indicators ◽  
Histopathological Correlation ◽  
History Of ◽  
The Mean

BACKGROUND Endometrial cancer (EC) is also the second most common gynaecologic malignancy in developing countries, with an incidence of 5.9 per 100,000 women. Due to the multiple modifiable factors, a better understanding of the prognostic indicators can lead to early detection and treatment. The purpose of this study was to evaluate the frequency and the distribution of various risk factors, epidemiological factors, and histological patterns of patients diagnosed with endometrial carcinoma in a tertiary teaching hospital in south India and compare them with similar studies. The compiled findings of 60 consecutive cases that presented to our tertiary care teaching hospital in Kerala, south India, over oneand-a-half-year period were studied. METHODS This study was essentially an ex post facto retrospective study done on 60 patients for one and half years. Retrospective data collection and compilation were done with previously prepared structured questionnaires in patients with histologically proven endometrial carcinoma. All cases were subjected to hysterectomy with post-surgical histopathology correlation. A study of the risk factors, general epidemiological characteristics, endometrial biopsy findings, and post-surgical histopathology was done. RESULTS The mean age at presentation was 59.83 years. The mean age of menarche was 13.72 years, and menopause was 49.42 years. The majority of patients were married, multiparous, and presented with bleeding per vaginum (77 %). 61.7 % of the patients had a history of hypertension, 31.7 % had a history of hypothyroidism, and 43.3 % had a history of diabetes mellitus in the study population. The most common histopathological type by endometrial biopsy and histopathological correlation was endometrioid adenocarcinoma (88.3 %). CONCLUSIONS Postmenopausal age group, with early menarche and late menopause, high body mass index (BMI), thickened endometrium on ultrasound, and atrophic uterus were some of the features associated with endometrial carcinoma. The most common histological subtype was found to be endometrioid carcinoma KEYWORDS Endometrial Carcinoma, Risk Factors, Prognostic Indicators

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