scholarly journals Profile of Ectopic Pregnancy at Western Regional Hospital

2017 ◽  
Vol 13 (4) ◽  
pp. 397-400
Author(s):  
Rabi Prasad Regmi ◽  
Shyam Sundar Parajuly ◽  
Ananda Bahadur Shrestha ◽  
Dela Joshi Singh ◽  
Sarvesh Gyawali
Keyword(s):  
Ectopic Pregnancy ◽  
Discharge Summary ◽  
Regional Hospital ◽  
Contraceptive Device ◽  
Beta Hcg ◽  
Number Of Patients ◽  
Obstetric Emergencies ◽  
Life Threatening ◽  
Western Regional ◽  
Ectopic Pregnancies

Background & Objective: Ectopic pregnancy (EP) is one of the common life threatening obstetric emergencies which if not recognized and managed on time can be ruptured which could be a cause of death.  Unfortunately, the world wide incidence of EP is in an increasing trend. The main objective of this study is to assess the frequency, trends, blood loss and management aspects of EP at Western Regional Hospital (WRH), Pokhara.Materials & Methods: The study was carried out in the department of Obstetrics and Gynecolgy, WRH. Data were collected and analyzed from patient’s records and discharge summary during the period of 2072-1-1 to 2072-9-30 B.S, retrospectively. Total number of hospital deliveries (7250) during this period was obtained from record section. Diagnosis of EP was made by urine beta- hcg (human chorionic gonado-tropin hormone) test and pelvic ultrasonography.Results:  The incidence of ectopic pregnancy was one in every 168 deliveries. Forty three such ectopic pregnancies were diagnosed and managed during the period, the mean age was 26.34 years, the median being the age of 25-29 years (16 patients). Twenty seven patients had ruptured ectopic pregnancy. Of all the cases, the number of patients with heterotopic pregnancy and intra uterine contraceptive device (IUCD) in situ were one for each (2.3%). All cases were satisfactorily managed with no mortality, and a mean of 6.1 days of hospital stay.Conclusion: Ectopic pregnancies are common cause of hospital admission, irrespective of patient's age all of which were managed at WRH with no mortality.

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 Surgical intervention in ectopic pregnancies

2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Fouzia Rasool Memon ◽  
Mini Poothavelil ◽  
Samreen Memon
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Surgical Intervention ◽  
University Hospital ◽  
Time Interval ◽  
Presenting Symptoms ◽  
Beta Hcg ◽  
Ultrasound Findings ◽  
Ectopic Pregnancies ◽  
Study Setting

Objectives: To find out the negative laparoscopy rate for suspected ectopic pregnancy. Study Design: Retrospective cohort study. Setting: Electronic medical record databases in North Cumbria University Hospital, Carlisle, United Kingdom. Period: August 2014 to August 2018. Material and Methods: The data of total 150 laparoscopies performed for ectopic pregnancy management was collected for gestational age at presentation, symptoms, serial beta human chorionic gonadotrophic hormone (HCG) levels, ultrasound findings, time interval for diagnosis, time to surgery and histology. Results: One hundred and fifty patients (52 under 5 weeks and 98 over 5 weeks’ gestation) were incorporated into this study. The primary presenting symptoms were pain and vaginal bleeding. Suboptimal rise in serial beta HCG (performed 48 hours apart) was seen in 69 patients (46%) while other 81 patients (54%) had confirmed ectopic on USS and were offered surgical management after the scan. One hundred forty for women (96%) went for surgical management and one patient had conservative management as she was asymptomatic with low HCG(less than 1000IU) at the first visit and rapid drop in serial BHG results. Fifty three women (35%) had surgery on the same day when they had ectopic pregnancies seen on USS, 63 (42%) went to theatre for surgery between 0-6 days, while 34 patients (23%) had surgery between 7-14 days of USS. All women were operated through laparoscopic route and tubal ectopic pregnancies were confirmed at laparoscopy. There was no negative laparoscopy in our study period. Conclusion: Judicious and timely surgical intervention made it possible to treat every case through laparoscopic route with zero negative laparoscopy rate.

scholarly journals Non-surgical management of unruptured tubal ectopic pregnancy

2017 ◽  
Vol 6 (7) ◽  
pp. 3041
Author(s):  
Anjali Choudhary ◽  
Priyanka Chaudhari ◽  
Neeta Bansal
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Management ◽  
Expectant Management ◽  
First Trimester ◽  
Response To Treatment ◽  
Surgical Trauma ◽  
Tubal Ectopic Pregnancy ◽  
Beta Hcg ◽  
Surgical Options ◽  
Ectopic Pregnancies

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.

scholarly journals Retroperitoneal Ectopic Pregnancy: Diagnosis and Therapeutic Challenges

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Salma Ouassour ◽  
Abdelhai Adib Filali ◽  
Mohamed Raiss ◽  
Rachid Bezad ◽  
Zakia Tazi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Ectopic Pregnancy ◽  
Management Strategy ◽  
Clinical Signs ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Life Threatening ◽  
History Of ◽  
Ectopic Pregnancies

Background. Retroperitoneal ectopic pregnancy is extremely rare. This unusual location represents a great challenge for clinicians due to the difficulties of diagnosis and high risk of life-threatening complications. Case Report. We report the case of a spontaneous early pregnancy of undetermined location in a patient with a history of previous laparoscopic surgery. Diagnosis steps using clinical examination, ultrasound, and magnetic resonance imaging led to the localization of the pregnancy, in the left side of the para-aortic region, in the retroperitoneal space. Conclusion. Retroperitoneal ectopic pregnancy is an uncommon entity with rather complex pathogenesis. Clinicians should carefully interpret clinical signs, biological findings, and imaging features and be aware of unusual locations such as the retroperitoneum for ectopic pregnancies. Early diagnosis and appropriate management strategy are conditio sine qua non for successful treatment outcomes.

scholarly journals HUBUNGAN PENGGUNAAN KONTRASEPSI DENGAN KEJADIAN KEHAMILAN EKTOPIK TERGANGGU DI BLU RSUP PROF. DR. R. D. KANDOU MANADO PERIODE 2009 – 2013

e-CliniC ◽  
2014 ◽  
Vol 2 (3) ◽  
Author(s):  
Deanette M. R. Aling ◽  
Juneke J. Kaeng ◽  
John Wantania
Keyword(s):  
Ectopic Pregnancy ◽  
Developed Countries ◽  
Social Medicine ◽  
Obstetrics And Gynecology ◽  
Contraceptive Methods ◽  
Chi Square ◽  
Number Of Patients ◽  
Prior Use ◽  
Ectopic Pregnancies ◽  
Chi Square Analysis

Abstract: Ectopic pregnancy accounts for 1 in 200 (5-6%) maternal mortality in developed countries.2 According to the WHO, with over 60 000 annual cases in Indonesia– that is 3% of its population, the number of ectopic pregnancies in Indonesia is estimated to be on the brink to cases in developed countries.6 A risk factor for ectopic pregnancy that has surged over the years is the use of contraceptive methods. According to the research at the Department of Epidemiology and Social Medicine University of Brussels in the 90s and two consecutive research the at the Department of Obstetrics and Gynecology BLU RSUP Prof. dr. R. D. Kandou Manado in 2001 and 2011, the use of contraceptive methods have proven to have significant correlation with the incidence of ectopic pregnancy (p>0.05).5,10The issues above are what underlie the aim of this research – that is to investigate the possibility for ectopic pregnancies to occur in patients diagnosed with ectopic pregnancy with prior use of contraceptive methods at the Department of Obstetrics and Gynecology BLU RSUP Prof. dr. R. D. Kandou Manado from October 2009 – October 2013. The method applied for this research is by performing a 5 year retrospective study - analyzing the number of patients with ectopic pregnancy as well as those with prior use of contraceptive methods. The result from a Chi-Square analysis is p = 0.457, where if p < 0.05, means there is a significant correlation. Thus with such result, it is proven that there is no significant correlation between the use of contraceptive methods with the incidence of ectopic pregnancy. Keywords: ectopic pregnancy, contraceptive methods.   Abstrak: Kehamilan Ektopik Terganggu (KET) merupakan penyebab 1 dari 200 (5-6%) mortalitas maternal di negara maju.2 Dengan 60.000 kasus setiap tahun atau 3% dari populasi masyarakat, angka kejadian KET di Indonesia diperkirakan tidak jauh berbeda dengan negara maju, menurut WHO.6 Adapun salah satu faktor risiko KET yang dinilai semakin meningkat dewasa ini adalah pemakaian alat-alat/ metode kontrasepsi. Ditinjau dari penelitian di Department of Epidemiology and Social Medicine University of Brussels pada tahun 90an dan penelitian di BLU RSUP Prof. dr. R. D. Kandou Manado pada tahun 2001 dan 2011, pemakaian alat kontrasepsi dengan kejadian KET memiliki hubungan yang signifikan, dengan p > 0.05. Masalah tersebut yang menjadi dasar tujuan penelitian ini, yaitu untuk menindaklanjuti kemungkinan terjadinya KET pada pasien-pasien KET dengan riwayat pemakaian kontrasepsi, dengan memberikan gambaran mengenai data-data kasus KET dengan riwayat  penggunaan kontrasepsi yang diperiksa di bagian Obstetri dan Ginekologi BLU RSUP Prof. dr. R. D. Kandou Manado periode Oktober 2009 – Oktober 2013.Metode yang digunakan pada penelitian ini adalah dengan melakukan studi retrospektif, yaitu dengan melakukan pendataan jumlah pasien KET, serta riwayat penggunaan kontrasepsi oleh pasien-pasien KET tersebut dalam kurun waktu 5 tahun. Hasil yang ditemukan memperlihatkan hasil uji Chi-Square adalah p = 0.457, dimana jika nilai p < 0.05, maka dikatakan terdapat hubungan yang signifikan. Oleh karena nilai p pada uji Chi-Square di tabel 4.4.A >0.05, maka dapat dikatakan bahwa tidak terdapat hubungan yang signifikan antara riwayat penggunaan kontrasepsi dengan kejadian KET. Kata kunci: KET (Kehamilan Ektopik Terganggu), kontrasepsi.

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 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

Caution with bilateral salpingectomy and consideration of tubal stump ectopic in IVF

2020 ◽  
Vol 13 (11) ◽  
pp. e235893
Author(s):  
Swee Lin Yip ◽  
Shahul Hameed Mohamed Siraj ◽  
Jerry Kok Yen Chan
Keyword(s):  
Ectopic Pregnancy ◽  
Cystic Mass ◽  
In Vitro Fertilisation ◽  
Beta Human Chorionic Gonadotropin ◽  
Life Threatening ◽  
History Of ◽  
Bilateral Salpingectomy ◽  
Ectopic Pregnancies ◽  
The Right

We report a 35-year-old female patient with a history of bilateral salpingectomy from ectopic pregnancies presenting with a positive serum beta-human chorionic gonadotropin (bhCG) result following in vitro fertilisation (IVF) treatment. Apart from per vaginal spotting, she remained asymptomatic. Initial ultrasound showed an empty uterus with a cystic mass on the right side of the uterus. Serum beta-hCG was trended. A follow-up pelvic ultrasound 1 week later showed a live pregnancy in the right adnexa. A diagnostic laparoscopy was performed, which revealed an unruptured right stump ectopic pregnancy that was successfully removed. As a stump ectopic pregnancy can be a potentially life-threatening occurrence, we emphasise caution with salpingectomy and the consideration of tubal stump ectopic pregnancies following IVF treatment.

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