scholarly journals Medical Management of Cervical Ectopic Pregnancy

2016 ◽  
Vol 22 (2) ◽  
Author(s):  
Wasima Arif ◽  
Farrah Mukhtar ◽  
Iffat Naheed ◽  
Farhat Naz

Cervical ectopic pregnancy is a rare condition with implantation in the endocervical canal below the closed internal os. It accounts for less than 1% of all ectopic pregnancies. It is associated with high morbidity and mortality. A case of cervical ectopic pregnancy is reported. She was a young nulliparous female, timely referred from peripheral hospital. She was treated successfully with medical management and thus fertility was preserved

Author(s):  
Nitesh Meena ◽  
Radheshyam Bairwa ◽  
Savitri Sharma

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in department of obstetrics and gynaecology, jhalawar medical college, Jhalawar, Rajasthan, India from January 2019 to October 2019. All patients admitted with diagnosis of ectopic pregnancy, either ruptured or unruptured where included in the study.Results: Total 52 patient of ectopic pregnancy were studies. Majority (63.46%) of patients belong to the age group 21-30 years. Ectopic pregnancy was most commonly noted in nulliparous woman (44.23%) Majority of the case (31%) had no risk factors among remaining (34.61%), previous MTP (17%), (17-30%) previous ectopic (9%) and PID (15-38%) were identified risk factors. Ampulla (75%) was the most common site for ectopic pregnancy. 57% of the cases were on the right side. The common presenting complaints were pain in abdomen (81%) bleeding/ spotting per vaginal (42%). There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital screening of high-risk case, early diagnosis and early intervention reduce the morbidity and mortality in ectopic pregnancies.


Author(s):  
Mridula Shrivastava ◽  
Hemlata Parashar ◽  
Jyoti Nath Modi

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. The incidence of ectopic pregnancy is on a rise globally. Risk factors and causes for ectopic pregnancy may vary with the setting and geographically.Methods: A retrospective analysis of all operated ectopic pregnancies over a 5-year period; between June 2011 to May 2016, was done. Surgically confirmed cases were included in this study and a detailed analysis of presenting symptoms, age, parity and high risk factors was carried out.Results: A total of 50 patients were operated for ectopic pregnancy at our hospital during the study period. Analysis was done for 47 of these due to incomplete data for 3 patients. Majority (62%) of patients belonged to the age group 20-29 years and were gravida 3 and above. Ninety two percent were ruptured ectopic. Sixty two percent ectopic pregnancies were on right side. The common presenting complaints were pain in abdomen (81%) and bleeding/spotting per vaginum (43%). The mean duration between onset of symptoms and reporting to hospital was one and a half day and the average time between admission to hospital and surgery was 9 hours. The ectopic pregnancies were managed surgically in all cases. No obvious risk factors were identified in 34% patients. Among the remaining, previous MTP (17%), previous ectopic (9%) and PID (7%) were identified risk factors. There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital. Screening of high risk cases, early diagnosis and early intervention reduces the morbidity and mortality in ectopic pregnancies.


Author(s):  
Indu Verma ◽  
Charvi Chugh ◽  
Unmesh Santpur ◽  
Pratibha Pundhir

Cervical ectopic pregnancy is rare condition which occurs in less than 1% of all ectopic pregnancies. Early diagnosis is a key to successful management; delayed diagnosis can lead to significant morbidity and fertility loss of the mother. We present a case of woman who presented with vaginal bleeding and lower abdominal pain for 3 days following amenorrhea of 3 ½ months. Ultrasound examination done outside was suggestive of left tubal ectopic pregnancy whereas scan done at our hospital indicated either uterine rupture within intraperitoneal sac or a cervical ectopic pregnancy. She was taken up for laparotomy and hysterectomy since she was bleeding profusely, and it was lifesaving.


2017 ◽  
Vol 6 (2) ◽  
Author(s):  
Nupur Tamhane ◽  
Aditi Parikh ◽  
Vivek M. Joshi

Abstract Cervical ectopic pregnancy is defined as implantation of the embryo in the endocervical canal below the level of the internal os. It is a rare condition that accounts for 0.15% of all ectopic pregnancies. As it can lead to complications such as uncontrolled hemorrhage, it is associated with high morbidity and mortality. This paper illustrates a rare case of a 2nd trimester cervical pregnancy with failed conservative management due to the limitations of ultrasonography. Successful conservative management requires not only early diagnosis but also usage of other sophisticated techniques such as magnetic resonance imaging (MRI) that can help in detecting adherent placenta.


2005 ◽  
Vol 25 (1) ◽  
pp. 82-83 ◽  
Author(s):  
R Gosakan ◽  
S Arutchelvam ◽  
HH Gergis ◽  
E Emovon

Author(s):  
Anjali Choudhary ◽  
Priyanka Chaudhari ◽  
Neeta Bansal

Background: Ectopic pregnancy is still the leading cause of pregnancy related morbidity in the first trimester. Since majority of the women who present with ectopic pregnancies are sub fertile and young, there is a role for non-surgical options of managing these pregnancies. Expectant and medical management not only serves to conserve the fallopian tubes but also saves women from surgical trauma and morbidity. The objective of this retrospective study was to share our experience of treating un-ruptured tubal ectopic pregnancies conservatively.Methods: Women diagnosed with un-ruptured tubal ectopic pregnancy, fit for conservative /medical management were included. Women with serum beta HCG levels less than 1000 mIU/L were treated expectantly and women with Bet HCG levels >1000 but <10,000 mIU /L were given Injectable methotrixate. Response to treatment was monitored by serial beta HCG levels.Results: Total 37 women included in the study.12% women showed complete resolution with expectant treatment alone and 88% resolved after a single dose methotrixate.Conclusions: Many women with un-ruptured tubal ectopic pregnancies would benefit from expectant management, or methotrixate therapy. Methotrixate used in carefully selected women is safe and effective in resolving these cases with good post treatment reproductive outcome.


2018 ◽  
Vol 03 (02/03) ◽  
pp. 198-203
Author(s):  
Sree Rama Mellacheruvu ◽  
Kousalya Chakravarthy ◽  
Khaliq Ahmed

AbstractPeripartum cardiomyopathy (PPCM) is a rare idiopathic cardiomyopathy having an incidence of less than 0.1%. PPCM is associated with high morbidity and mortality rates ranging from 5 to 32%. In this review, the authors report a series of five PPCM cases. The case reports included pregnant women with PPCM, admitted in the hospital from October 1, 2017 to June 1, 2018 over a period of 9 months who required cesarean section. The authors aim to discuss the presentation, optimization, anesthetic management, and postoperative care of this rare condition. One of the cases was a booked case. The remaining four pregnant patients were referred in late pregnancy with features of congestive cardiac failure. One patient was in acute pulmonary edema, required intubation, and subsequently had cesarean section under general anesthesia. Four patients were managed with incremental epidural anesthesia. The need for proper preoperative optimization and intra- and postoperative management was discussed. The authors had one maternal mortality in our series. There was no neonatal mortality. Early diagnosis of PPCM, prompt treatment of heart failure, planning the delivery, and postpartum care can decrease maternal morbidity and mortality. Incremental epidural dosing can be used for cesarean section and has the advantage of stable hemodynamic status without the risks associated with general anesthesia.


2019 ◽  
Vol 27 (2) ◽  
pp. 171-175 ◽  
Author(s):  
Manish Gupta ◽  
Ginni Datta

Introduction Oesophageal perforation is a rare condition and has high morbidity and mortality. Both the morbidity and mortality are directly related to the delay in diagnosis and start of treatment. Primary closure with drainage is recommended if perforation is detected in less than 24 hours. Treatment for delayed or missed rupture of oesophagus is not very clear and is controversial. Case Report We hereby report a case of delayed diagnosed cervical oesophagus rupture following gunshot, which was primarily repaired. Special emphasis is on newer technique of fistula localization using oro-oesophageal tube and AMBU for better closure. The fistula closure was successful and no there were no post-operative complications. Discussion The symptoms and signs on presentation of patient of cervical oesophagus perforation are discussed along with the differing treatment paradigms for early versus late presentation. Surgical repair with primary closure may be undertaken, even in late presentation of oesophagus rupture. This technique of oro-oesophageal tube used along with AMBU, may be useful in cases of both cervical and upper thoracic oesophagus rupture. 


2020 ◽  
pp. 1-2
Author(s):  
Rana Choudhary ◽  
Seema Pandey ◽  
Priyanka Vora

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.


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