scholarly journals Holistic approach in covid-19 phobia causing near missing ectopic pregnancy treatment

2021 ◽  
Vol 2 (2) ◽  
pp. 057-065
Author(s):  
Eddy Hartono ◽  
Ary Rizqi Rachman ◽  
Nuraini Abidin ◽  
Ajardiana Idrus
Keyword(s):  
Ectopic Pregnancy ◽  
Pregnancy Complications ◽  
Health Workers ◽  
Holistic Approach ◽  
First Trimester ◽  
Near Miss ◽  
Diagnosis Delay ◽  
Missed Abortion ◽  
First Trimester Of Pregnancy ◽  
Fear And Anxiety

Ectopic pregnancy is one of the major cause of death in the first trimester of pregnancy. Complications may result from misdiagnosis, diagnosis delay, or mistreatment. COVID-19 is currently became pandemic. There is still no specific recommendations for manage pregnant women with COVID – 19. Mrs. EF, 34 y.o., G2P1011 admitted to Wahidin Sudirohusodo Hospital Makassar referred from Hermina Hospital dianosed with missed abortion and suspected of COVID-19 infection. She was first refused to undergo COVID – 19 screening and diagnostic test, though finally agree to proceed with examination. She was definitively diagnosed with ectopic pregnancy following 4 days of undetermined COVID – 19 status. Emergency explorative laparotomy was then performed. This is a maternal near miss case. Delay in performing COVID – 19 examination may compromise management of true emergency obstetrics situation. COVID-19 phobia is one factor that describe excessive fear and anxiety about the transmission of corona virus among health workers. Health workers may be reluctant in treating patient because of undetermined status of COVID-19 causing diagnosis delay.

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.

scholarly journals Role of Maternal Serum Glycodelin as Predictor of Ectopic Pregnancy in First Trimester

2018 ◽  
Vol 7 (4) ◽  
pp. 467-470
Author(s):  
Wasan Wajdi Ibrahim ◽  
Afraa Mahjoob Al-Naddawi ◽  
Hayder A. Fawzi
Keyword(s):  
Ectopic Pregnancy ◽  
Predictive Value ◽  
First Trimester ◽  
Maternal Serum ◽  
Intrauterine Pregnancy ◽  
Receiver Operator Curve Analysis ◽  
Medical City ◽  
First Trimester Of Pregnancy ◽  
Control Study

Objectives: Assessment of glycodelin (GD) as a marker for unruptured ectopic pregnancy (EP) in the first trimester of pregnancy. Materials and Methods: This case-control study was conducted during June 2016 to May 2017 in the Obstetrics and Gynecological Department of Baghdad University at Baghdad teaching hospital/medical city complex. In this study, 100 pregnant women in their first trimester of pregnancy were included after clinical and ultrasonic findings. Results: Based on the results, GD levels in EP were significantly lower than those with normal intrauterine pregnancy (1.58 ± 1.18 vs. 30.1 ± 11.9). In addition, using receiver operator curve analysis, the cut-off GD level of 9.5 and less had acceptable validity results (100% sensitivity, 100% specificity, 95% positive predictive value, 100% negative predictive value, and accuracy 100%) to predict EP. Conclusions: In general, serum GD is considered as an excellent predictor of unruptured EP.

Urinary Chorionic Gonadotrophin Determination

1966 ◽  
Vol 12 (9) ◽  
pp. 577-585 ◽  
Author(s):  
Derek Watson
Keyword(s):  
Normal Values ◽  
First Trimester ◽  
Diagnostic Value ◽  
Chorionic Gonadotrophin ◽  
Routine Method ◽  
Normal Range ◽  
Missed Abortion ◽  
Abnormal Pregnancy ◽  
Endogenous Production ◽  
First Trimester Of Pregnancy

Abstract Successful laboratory tests for early pregnancy utilize the endogenous production and excretion of chorionic gonadotrophin (CG). There is wide variation in sensitivity and specificity of various biological and commercially available immunochemical methods for determining urinary CG levels. Normal values for immunochemically reactive CG during the first trimester of pregnancy are given. Serial determinations of CG have diagnostic value in assessing various abnormal pregnancy states. An abnormally increased urinary output of CG is observed in some neoplasms—e.g., chorionepithelioma, and a rapidly rising CG level is strongly suggestive of molar pregnancy. Urinary CG levels falling below the normal range mayindicate an ectopic pregnancy or an inevitable, incomplete, or "missed" abortion. The immunochemical CG determination also offers a sensitive, simple, and convenient routine method for following patients who have been treated for hydatidiformmole or chorionepithelioma.

Primary Ovarian Ectopic Pregnancy Misdiagnosed as First-Trimester Missed Abortion

2005 ◽  
Vol 24 (4) ◽  
pp. 539-543 ◽  
Author(s):  
Vicki Nisenblat ◽  
Zvi Leibovitz ◽  
Joseph Tal ◽  
Shlomi Barak ◽  
Israel Shapiro ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
First Trimester ◽  
Missed Abortion

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 Incidence of early pregnancy complications, management protocols and its outcome in patients at Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat, India

2017 ◽  
Vol 6 (9) ◽  
pp. 3837
Author(s):  
Akansha . ◽  
Nagajan Bhadarka
Keyword(s):  
Ectopic Pregnancy ◽  
Early Pregnancy ◽  
Pregnancy Complications ◽  
Medical Science ◽  
First Trimester ◽  
Related Complication ◽  
Hospital Patients ◽  
Clinical Benefits ◽  
Threatened Abortion ◽  
Vesicular Mole

Background: Early Pregnancy Complications can cause significant morbidity and mortality. Pregnant women an present with h/o amenorrhea, abdominal pain, vaginal bleeding or incidental scan finding of missed abortion, ectopic pregnancy and vesicular mole, features of hypermesis gravidorum like fatigue, nausea, vomiting, dryness and diminished urine output. The objective of present study was to analyze the incidence of various early pregnancy complications, assess the protocols for diagnosing these complications and their management.Methods: Present study was conducted at the Department of Obstetrics and Gynecology, Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat. All the women with first trimester pregnancy with different complications were included in this study while those women with uneventful first trimester were excluded. The inducted women were registered on pre-designed proforma. Studied variables including demographic details, gestational period, type of complications, risk factors, treatment and outcome.Results: Out of 740 total admissions 439 abortions of which incomplete abortion was 262, missed abortions were 132, threatened abortion 42 and 3 cases of septic abortion, ectopic pregnancy 154, molar pregnancy33, hyperemesis 31. There were about 63 cases of non-pregnancy related complication reported during early pregnancy like 31 with UTI, 9 with renal colic, 2 cases of appendicitis, four cases of asymptomatic cholelithiasis, 2 cases of hepatitis, 5 cases of ovarian cyst complicating pregnancy, 2 cases of ovarian torsion. Their mean age was 30.8+6.8 years.Conclusions: Study was successful in creating a confidence among trainees when following the recommended protocols as well as delivering clinical benefits to the hospital, patients and staff. Early gynecological consultation and bedside ultrasound scanning within the emergency department were key requirements for any emergency concerns.

scholarly journals Epidemiology of ectopic pregnancy at Laquintinie Douala hospital (Cameroon): prevalence survey, clinical profile, therapeutic and transfusion issues

2020 ◽  
Vol 10 (1) ◽  
pp. 44
Author(s):  
Henri Essome ◽  
Thomas O. Egbe ◽  
Gregory E. Halle ◽  
Théophile N. Nana ◽  
Merlin Boten ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
First Trimester ◽  
Sexual Partners ◽  
Age Group ◽  
Prevalence Survey ◽  
Multiple Sexual Partners ◽  
Sexually Transmitted ◽  
First Trimester Of Pregnancy ◽  
Therapeutic Profile

Background: Pregnancy is a serious pathology of the first trimester of pregnancy and is the leading cause of death. The objective of our work was to determine the hospital prevalence of ectopic pregnancy (EP), to describe the epidemiological, clinical and therapeutic profile given the often-haemorrhagic context at Laquintinie Hospital in Douala.Methods: We carried out a retrospective study over 10 years, from January 1st, 2007 to December 31st, 2016, using the operating theatre registers and the files of patients admitted during this period for ectopic pregnancy in the gynaecology and obstetrics department of the Laquintinie Hospital in Douala.Results: A total of 905 cases of EP for 32,595 deliveries were recorded, for an overall incidence of 2.8%. EP mainly affected the age group of 25 to 35 (60.6%), single people (57.9%) and housewives (46.6%). The risk factors found were similar to those of cervical cancer, namely multiple sexual partners (80.4%), the precocity of sexual intercourse under 18 years (54.1%) and sexually transmitted infections (52.5%). The symptomatic triad (pelvic pain, amenorrhea and metrorrhagia) was found in 46.1% of cases with a respective order of frequency of 96.9%, 77.3% and 63.6% The management was essentially surgical by radical laparotomy (97% of cases). Two of the 07 deaths were due to religious considerations.Conclusions: EP remains a frequent pathology in our environment with a heavy toll of tubal amputations and death.

scholarly journals Implementation Study of Patient-Ready Syringes Containing 25 mg/mL Methotrexate Solution for Use in Treating Ectopic Pregnancy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
R. Respaud ◽  
A. S. Gaudy ◽  
C. Arlicot ◽  
J. F. Tournamille ◽  
M. C. Viaud-Massuard ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Storage Period ◽  
Cost Effective ◽  
First Trimester ◽  
Storage Conditions ◽  
Treatment Delays ◽  
Effective Delivery ◽  
First Trimester Of Pregnancy ◽  
The Stability ◽  
Physical And Chemical

Background.Ectopic pregnancy (EP) is a significant cause of morbidity and mortality during the first trimester of pregnancy. Small unruptured tubal pregnancies can be treated medically with a single dose of methotrexate (MTX).Objective.The aim of this study was to evaluate the stability of a 25 mg/mL solution of MTX to devise a secure delivery circuit for the preparation and use of this medication in the management of EP.Method.MTX solutions were packaged in polypropylene syringes, stored over an 84-day period, and protected from light either at +2 to +8°C or at 23°C. We assessed the physical and chemical stability of the solutions at various time points over the storage period. A pharmaceutical delivery circuit was implemented that involved the batch preparation of MTX syringes.Results.We show that 25 mg/mL MTX solutions remain stable over an 84-day period under the storage conditions tested. Standard doses were prepared, ranging from 50 mg to 100 mg. The results of this study suggest that MTX syringes can be prepared in advance by the pharmacy, ready to be dispensed at any time that a diagnosis of EP is made.Conclusion.The high stability of a 25 mg/mL MTX solution in polypropylene syringes makes it possible to implement a flexible and cost-effective delivery circuit for ready-to-use preparations of this drug, providing 24-hour access and preventing treatment delays.

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