scholarly journals Ectopic Pregnancy Following Interval Tubal Sterilization

2017 ◽  
Vol 5 (2) ◽  
pp. 77-80
Author(s):  
Deepak Shrestha ◽  
Sebina Baniya ◽  
Sudeep Regmi
Keyword(s):  
Ectopic Pregnancy ◽  
Failure Rate ◽  
Uterine Cavity ◽  
Prior History ◽  
Emergency Laparotomy ◽  
Tubal Sterilization ◽  
Mobile Mass ◽  
History Of ◽  
Permanent Contraception ◽  
Urine Pregnancy Test

Introduction:  Tubal sterilization is a highly effective method of permanent contraception. However, pregnancy can still occur following a successful procedure. Published literatures report a failure rate of 0.13-1.3% and 15-33% of such pregnancies are likely to be ectopic. Case report: A 33 years para three lady with prior history of tubal ligation presented with generalized abdominal pain and several episodes of vomiting. Bimanual examination revealed a soft and mobile mass of 2 x 3 cm in right adnexa. Urine pregnancy test was positive and ultrasonogram showed a heterogeneous mass of 3.4 x 3.3 cm in right adnexa with empty uterine cavity. Culdocentesis resulted in aspiration of frank non-clotting blood. She then underwent emergency laparotomy with bilateral salpingectomy for ruptured ectopic pregnancy. Conclusion: Ectopic pregnancy after tubal sterilization though rare is not entirely impossible. All women who are offered this procedure should always be educated about its failure rate. And in women presenting with acute abdomen, a prior history of tubal sterilization doesn't preclude the possibility of ectopic pregnancy.

scholarly journals Broad ligament ectopic pregnancy: a dilemma to diagnose

2017 ◽  
Vol 6 (5) ◽  
pp. 2109 ◽  
Author(s):  
Shweta Mittal ◽  
Vinita Gupta ◽  
Dolly Chawla ◽  
Seema Pundir
Keyword(s):  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Emergency Laparotomy ◽  
Vaginal Examination ◽  
Extrauterine Pregnancy ◽  
History Of ◽  
The Right ◽  
Cervical Motion ◽  
Cervical Motion Tenderness ◽  
Urine Pregnancy Test

Broad ligament ectopic pregnancy is a rare and serious form of extrauterine pregnancy with a high risk of maternal mortality. There are no specific clinical features. Ultrasonography may help in diagnosis but definitive diagnosis is made only during surgery. A 20-year-old woman with previous 2 abortions presented with acute abdomen. She had no history of amenorrhoea but there was history of two episodes of bleeding in the last month at an interval of 14 days, each episode lasting for two-three days. The last episode of bleeding was 10 days back. Her urine pregnancy test was done and it was positive. There was marked abdominal tenderness with guarding and rigidity. Per vaginal examination revealed marked tenderness in the right fornix and cervical motion tenderness, uterus size could not be assessed due to tenderness.  It was diagnosed as a case of ruptured ectopic pregnancy. Since she was haemodynamically unstable, emergency laparotomy was done. She had a right sided broad ligament ectopic pregnancy which had ruptured. The tissue was completely removed and haemostatic sutures were taken. High index of clinical suspicion, early diagnosis and prompt surgery is the key to management.

scholarly journals Acute presentation of ruptured ovarian cyst secondary to torsion with ipsislateral concomitant ectopic pregnancy: A case report

2014 ◽  
Vol 3 (2) ◽  
pp. 54-56
Author(s):  
Mahendra R Pandey ◽  
Neeva Ojha
Keyword(s):  
Acute Abdomen ◽  
Ovarian Cyst ◽  
Emergency Laparotomy ◽  
Hospital Emergency ◽  
Obstetrics And Gynaecology ◽  
History Of ◽  
Gestational Sac ◽  
One Year ◽  
The Right ◽  
Urine Pregnancy Test

Twenty-one year unmarried regularly menstruating lady without history of amenorrhea presented with acute abdomen in TU Teaching Hospital –Emergency Department. On evaluation urine pregnancy test was positive. Urgent ultrasound revealed multiloculated cystic lesion measuring 8.5 x 8 x 6.7 cms in the right adnexa anterolateral to the uterus with no intrauterine gestational sac. She underwent emergency laparotomy with right salpingo-oophorectomy. On laparotomy there was twisted and ruptured right ovarian cyst with unruptured ampullary pregnancy on the same side. There was coexistence of these two conditions which presented as acute abdomen. DOI: http://dx.doi.org/10.3126/njog.v3i2.10834 Nepal Journal of Obstetrics and Gynaecology Vol.3(2) 2008; 54-56

scholarly journals Profile of Ectopic Pregnancy at Kathmandu Model Hospital

2016 ◽  
Vol 10 (2) ◽  
pp. 10-13
Author(s):  
HK Pradhan ◽  
G Dangal ◽  
A Karki ◽  
R Shrestha ◽  
K Bhattachan
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Discharge Summary ◽  
Reproductive Age ◽  
Emergency Laparotomy ◽  
Average Hospital ◽  
Pain Abdomen ◽  
Number Of Patients ◽  
History Of ◽  
Age Range

Aims: The study was done to analyze the epidemiology, diagnosis and treatment aspect of patients with ectopic pregnancy at Kathmandu Model Hospital.Methods: This was a retrospective study of patients with ectopic pregnancy who received treatment at Kathmandu Model Hospital from January 2008 to September 2015. Data were analyzed from patient records and discharge summary. Delivery number was obtained from maternity record.Results: There were 61 cases of ectopic pregnancy with the hospital incidence of 1.46%. Highest number of patients 20 (32.79%) were in the age range of 28-32 years. Most of the patients were nullipara 22 (36.06%) or with parity two 20 (32.79%). Some risk factors were found in 29 (47.54%) cases. The commonest risk factor was pelvic inflammatory disease in 12 (19.67%). All presented with pain abdomen, 48 (78.68%) had per vaginal bleeding, 17 (27.87%) presented in shock. Cervival excitation was present in 38 (62.29%). Urine for pregnancy test was positive in all and 37 (60.66%) had ultrasonography. Ten (16.39%) patients underwent emergency laparoscopic surgery and 40 (65.57%) had emergency laparotomy. Salpingectomy was required in 53 (86.89%) cases. The average hospital stay was 5 days.Conclusions: The study showed that ectopic pregnancy could occur at any reproductive age without obvious risk factors. Although not all patients gave history of amenorrhoea, pain abdomen was present in all.

scholarly journals The Challenge of the Non-Compliant Patient: A Case of Caesarean Section Scar Ectopic Pregnancy

2021 ◽  
pp. 1-3
Author(s):  
Jessica Audet ◽  
Brittany Noel Robles ◽  
Nicolle M Arroyo Lluberas ◽  
Jessica Audet ◽  
Daniel Faustin ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Emergency Laparotomy ◽  
Pharmacological Management ◽  
Compliant Patient ◽  
Life Saving ◽  
Close Observation ◽  
Life Threatening ◽  
History Of ◽  
Ruptured Uterus

Ectopic pregnancy is a quite common and life-threatening pregnancy. The most common site of ectopic implantation of a fertilized embryo is the fallopian tube. In extremely rare situations, the embryo can implant in other locations, which makes the diagnosis and management even more complex. Although close observation of a new pregnancy is key in the diagnosis and treatment of an ectopic pregnancy, there is still a major risk of life-threatening outcomes. This is a case report of a 31-year-old patient with a history of multiple pregnancies who presented to a community hospital in the spring of 2021 with an ectopic caesarean scar pregnancy. A diagnosis of ectopic pregnancy was on a timely basis, and surgical management was advised. Upon refusal of treatment and admission, pharmacological management was initiated, but patient compliance challenged the success of the therapy. Patient non-compliance to close follow-up resulted in a ruptured uterus. Emergency laparotomy with supracervical hysterectomy was performed as a life-saving procedure.

scholarly journals Laparoscopic Management of an Abdominal Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Aarthi Srinivasan ◽  
Suzanne Millican
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Lower Abdominal Pain ◽  
Pain Patient ◽  
Prior History ◽  
Intrauterine Pregnancy ◽  
Beta Hcg ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
The Right

Background. Ectopic pregnancy is one of the leading causes of significant maternal morbidity and mortality. Abdominal surgeries increase the risk of postoperative adhesions. We here present a case of omental ectopic pregnancy in a patient with a prior history of cesarean section.Case. A 20-year-old female presented with a two-day history of crampy lower abdominal pain. Patient was hemodynamically stable with a beta HCG of 1057 mI/mL. Transvaginal ultrasound did not show an intrauterine pregnancy but revealed an ill-defined mass in the midline pelvis extending to the right of the midline. Diagnostic laparoscopy revealed large clots in the pelvis with normal uterus and adnexa. Intra-abdominal survey revealed an omental adhesion close to the right adnexa with a hematoma. Partial omentectomy was completed and the portion of the omentum with the hematoma was sent to pathology for confirmation. Final pathology confirmed the presence of chorionic villi consistent with products of conception.Conclusion. Omental ectopic pregnancy is a rare diagnosis and often missed. We recommend careful intra-abdominal survey for an ectopic pregnancy in the presence of hemoperitoneum with normal uterus and adnexa. This can be safely achieved using laparoscopy in early gestational ages when the patient is hemodynamically stable.

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 Surgical Treatment of Ovarian Pregnancy

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Efthymia Thanasa ◽  
Ioannis Thanasas ◽  
Nikoleta Koutalia ◽  
Maria Mousia
Keyword(s):  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Wedge Resection ◽  
Transvaginal Ultrasound ◽  
Gonadotropin Level ◽  
Ovarian Pregnancy ◽  
History Of ◽  
Urine Pregnancy Test

The description of this case concerns the early diagnosis and the surgical treatment of a patient diagnosed with an ectopic ovarian pregnancy. A gravida 2, para 0 woman with a history of termination of pregnancy in the second trimester, was referred to the outpatients of the Gynecologic Department of the General Hospital of Trikala, reporting vaginal bleeding, accompanied by a deep, mild pain in the abdomen for a few days. The urine pregnancy test was positive. The transvaginal ultrasound in combination with the β-chorionic gonadotropin level was indicative of an ectopic pregnancy, and the surgical treatment of the patient was decided. Intraoperatively, the presence of an ovarian ectopic pregnancy was detected, and a wedge resection of the affected ovary was performed. The patient was discharged from our clinic on the third postoperative day, with instructions for weekly follow-up of the β-chorionic gonadotropin level until it returns to normal values.

scholarly journals GAMBARAN KEHAMILAN EKTOPIK TERGANGGU DI RSUP PROF. DR. R. D. KANDOU MANADO PERIODE 1 JANUARI 2012 - 31 DESEMBER 2013

e-CliniC ◽  
2015 ◽  
Vol 3 (2) ◽  
Author(s):  
Pricilia S. Lomboan ◽  
Linda Mamengko ◽  
John Wantania
Keyword(s):  
Ectopic Pregnancy ◽  
Uterine Cavity ◽  
Descriptive Study ◽  
Hemoglobin Level ◽  
Implantation Site ◽  
Uterine Tube ◽  
History Of ◽  
Normal Place

Abstract: In ectopic pregnancy, fertilized ovum is implanted and grows not in a normal place in the endometrium of the uterine cavity. If such pregnancy is threatened to an abortion then it is called threatened ectopic pregnancy. This study aimed to obtain the description of ectopic pregnancy at Prof. Dr. R. D. Kandou Hospital Manado related to age, husband’s job, marriage status, parity, pregnancy age, history of abortion, history of fluor albus, implantation site, and hemoglobin level. This was a retrospective descriptive study. The population consisted of all patients treated at Department of Obstetrics Gynecology Prof. Dr. R. D. Kandou Manado Hospital from January 1, 2012 - December 31, 2013. The results showed that of the 49 cases of ectopic pregnancy most of the patients were at the age of 21-35 year (65.30%); their husbands did not have any jobs (77.55%); married (73.46%); parity of 2 (32.65%); pregnancy age <8 weeks (55.10%); had no history of abortion (65.30%) or of fluor albus (81.63%); location in ampullae of uterine tube (97.95%); Hb level 9-10 g% and >10 g% (32.65%).Keywords: ectopic pregnancy, threatened ectopic pregnancyAbstrak: Kehamilan ektopik adalah kehamilan dengan ovum yang dibuahi berimplantasi dan tumbuh tidak di tempat yang normal yakni endometrium kavum uteri. Bila kehamilan tersebut mengalami proses pengakhiran (abortus) maka disebut kehamilan ektopik terganggu (KET). Penelitian ini bertujuan untuk mengetahui gambaran kehamilan ektopik terganggu di RSUP Prof. Dr. R. D. Kandou Manado dari segi umur, pekerjaan suami, status perkawinan, paritas, usia kehamilan, riwayat abortus, riwayat keputihan, lokasi implantasi, dan kadar Hb. Penelitian ini mnggunakan metode deskriptif retrospektif. Populasi ialah seluruh pasien yang dirawat di Bagian Obstetri Ginekologi RSUP Prof. Dr. R. D. Kandou Manado periode 1 Januari 2012 – 31 Desember 2013. Hasil penelitian memperlihatkan dari 49 kasus KET, pasien terbanyak berumur 21-35 tahun (65,30%); suami yang tidak bekerja (77,55%), status menikah (73,46%), paritas 2 (32,65%), usia kehamilan <8 minggu (55,10%), tanpa riwayat abortus (65,30%), tanpa riwayat keputihan (81,63%), lokasi pada ampula tuba (97,95%), serta kadar Hb 9-10 g% dan Hb >10 g% (32,65%).Kata kunci: kehamilan ektopik, KET

scholarly journals Conservative approach in the management of ectopic pregnancy

2021 ◽  
Vol 74 (1-2) ◽  
pp. 54-59
Author(s):  
Jelena Nisevic ◽  
Jelena Vukovic ◽  
Stevan Milatovic ◽  
Srdjan Djurdjevic
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Uterine Cavity ◽  
Cardiac Activity ◽  
Expectant Management ◽  
Methotrexate Therapy ◽  
Treatment Modalities ◽  
Prior History ◽  
Detailed Medical History

Introduction. Ectopic pregnancy is defined as the implantation of a fertilized ovum outside the uterine cavity and it is one of the leading causes of maternal morbidity and mortality. Localization and risk factors. The most common localization of ectopic pregnancy is within the fallopian tube, while other localizations include abdominal organs, ovaries, scars after previous cesarean sections, and cervix. Risk factors for ectopic pregnancy include previous fallopian tube injuries, infertility including multiple embryo transfers, use of contraceptives, smoking, older age, prior history of ectopic pregnancy, intentional abortions. Diagnostic procedures. Measurement of serum beta-human chorionic gonadotropin levels along with certain ultrasonography signs, i.e. extrauterine gestational sac, with a present yolk sac and/or embryo, with or without a cardiac activity, have the highest degree of reliability in making the diagnosis, whereas uncertain signs, such as ?blob? and ?bagel? signs, also have a high positive predictive value. Therapeutic modalities. Ectopic pregnancy can be treated by surgical, medical or expectant management. Expectant and medical management are reserved for hemodynamically stable patients who are adequately informed and where monitoring and control are possible. Conservative treatment. Before the initiation of treatment with methotrexate, it is necessary to rule out a vital intrauterine pregnancy, and consider the contraindications for methotrexate therapy, based on detailed medical history and laboratory tests. The Clinic of Obstetrics and Gynecology of the Clinical Center of Vojvodina uses a two-dose protocol by which methotrexate is administered intramuscularly and which has proven to be highly successful with few side effects. Surgical treatment modalities. Candidates for emergency laparoscopy or laparotomy are women who are hemodynamically unstable and who should not receive methotrexate. Conclusion. In properly selected patients, the success rate of methotrexate therapy is around 93%.

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