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 Management and Outcome of Ectopic Pregnancy in a Tertiary Care Center

2016 ◽  
Vol 2 (3) ◽  
pp. 45-47 ◽  
Author(s):  
Nagendra Prasad ◽  
T Alpana
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Care Center ◽  
Tertiary Care ◽  
Reproductive Age ◽  
Heterotopic Pregnancy ◽  
Emergency Laparotomy ◽  
Contraceptive Device ◽  
Tertiary Care Center ◽  
Operative Laparoscopy

ABSTRACT Objective To assess the results of management of ectopic pregnancy with respect to maternal morbidity and mortality and to analyze the risk factors. Materials and methods Hospital based cross-sectional study of 52 patients who were diagnosed as ectopic pregnancy in the reproductive age group of 15 to 44 years. Results A total of 62 patients with ectopic pregnancy were identified and studied. The rate of ectopic pregnancy was 1.26:100 deliveries. The mean age was found to be 26 years and majority of them were multigravida (Tables 1 and 2). The most common presenting symptom was abdominal pain (96.15%) (Table 3). Most patients had tubal ectopic pregnancy (94.2%). Ovarian ectopic occurred in two cases and 1 patient had heterotopic pregnancy. Emergency laparotomy was performed in 39 (62.90%) patients, 3 (5.77%) patients received methotrexate injection while 18 (29.0%) patients were managed by operative laparoscopy (Table 5). All cases of laparotomy did not require any further procedure. Out of three cases, 2 (66.66%) cases of medical treatment were successful while only 1 (33.33%) case proceeded to emergency laparotomy. No maternal death occurred. Intensive care unit (ICU) stay was needed in 5 patients. Risk factors were found in 67.3% and most common risk factor was found to be previous pelvic surgeries (56.45%) (Table 6). Heterotopic pregnancy was managed by expectant method. Two patients were of post-intrauterine contraceptive device. Conclusion Although there was no mortality in our study, morbidity was significant which required multiple blood transfusion and ICU admission. High degree of suspicion, early diagnosis using hormonal studies, sonography, and management in an institutional set up can reduce the associated morbidity. How to cite this article Alpana T, Nagarathnamma R, Prasad N. Management and Outcome of Ectopic Pregnancy in a Tertiary Care Center. J Med Sci 2016;2(3):45-47.

scholarly journals Clinical outcomes of ectopic pregnancy

2017 ◽  
Vol 6 (10) ◽  
pp. 4277
Author(s):  
Roopa Malik ◽  
Shaveta Jain ◽  
Nirmala Duhan ◽  
Daya Sirohiwal
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Past History ◽  
Management Strategies ◽  
Emergency Laparotomy ◽  
Mortality And Morbidity ◽  
History Of ◽  
Ectopic Pregnancies ◽  
A Prospective Study

Background: Ectopic pregnancy (EP) is a life threatening gynaecological emergency, and a significant cause of maternal mortality and morbidity worldwide. Aim of this study was to determine and evaluate the incidence, clinical presentation, risk factors, management strategies and outcome of the patients with EP.Methods: This was a prospective study of all cases of ectopic pregnancies admitted and managed at PGIMS Rohtak over a period of 1 year. All patients admitted through accident and emergency unit as well as the gynaecology clinic that were managed in gynaecological ward were included in the study. The diagnosis of EP was made by history, clinical examination, urinary pregnancy test and ultrasound examination. Patients were managed as per hospital protocol and relevant data on age, parity, clinical presentation, risk factors, management and findings at laparotomy, and the outcome of treatment were collected.Results: The incidence of ectopic pregnancy in this study was 1.056%. The mean age of the patients was 27±3 years. Of the 102 ectopic pregnancies, 86 (84.31%) were ruptured ectopic pregnancies, while 16 (15.68%) were unruptured ectopic pregnancies. The commonest clinical complaint was abdominal pain (97 of 102, 95.09%) History of previous abortion (induced or spontaneous) was the commonest risk factor (92 of 102, 90.19%) followed by past history of pelvic inflammatory disease (56 of 102, 54.90%). History of tubal surgery was present in 27 of 102 patients (26.47%). commonest surgical procedure done was emergency laparotomy followed by salpingectomy (67 of 102, 65.68%).Conclusions: EP is an important cause of maternal morbidity and mortality in early pregnancy and has remained a reproductive health challenge. Early diagnosis and treatment can improve reproductive outcomes. 

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 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

COVID-19: An Experience from a Tertiary Care Hospital of Nowshera

2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed
Keyword(s):  
Tertiary Care ◽  
Relevant Information ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Epidemic Area ◽  
History Of ◽  
Severity Of The Disease ◽  
Age Range

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.

scholarly journals A case report: spontaneous postpartum rupture of unscarred uterus

2018 ◽  
Vol 7 (8) ◽  
pp. 3420
Author(s):  
Swati Singh ◽  
Ravinder Ahlawat
Keyword(s):  
Risk Factors ◽  
Differential Diagnosis ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Emergency Laparotomy ◽  
Full Thickness ◽  
Uterine Incision ◽  
History Of ◽  
Rupture Of Uterus ◽  
Specific Symptoms

Rupture of uterus is characterized by a breach in the wall of the uterus involving its full thickness. An unscarred uterus rupture is uncommon. It has non-specific symptoms and presentation differs according to site and time of rupture. Authors report an unusual case of spontaneous rupture of unscarred uterus. A 32-year-old, pregnant woman, developed postpartum bleeding with no history of prior uterine incision. She was diagnosed as a case of rupture of uterus and emergency laparotomy was done. Early diagnosis and immediate surgical intervention may significantly improve the prognosis. Differential diagnosis of uterine rupture should always be kept in mind in all patients with or without risk factors.

scholarly journals Outcomes of Percutaneous Nephrolithotomy in Patients with Previous Ipsilateral Open Renal Stone Surgery

2020 ◽  
Vol 18 (2) ◽  
pp. 277-281
Author(s):  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parash Mani Shrestha ◽  
Biswa Raj Joshi
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Open Surgery ◽  
Renal Stone ◽  
Standard Technique ◽  
Study Groups ◽  
Average Hospital ◽  
Number Of Patients ◽  
History Of ◽  
Renal Stone Surgery ◽  
First Time

Background: Nephrolithiais is a recurrent disease. Recent advances have enabled stone surgeries to be performed by minimal invasive techniques; but still a large number of patients present with history of ipsilateral open renal stone surgery. Previous scar to the kidney and overlying muscles are fraught with possibility of increased complications. This study was conducted to evaluate the perioperative results of percutaneous nephrolithotomy in patients with a history of open stone surgery and to compare with those undergoing percutaneous nephrolithotomy for the first time.Methods: A retrospective study of all the percutaneous nephrolithotomy performed by standard technique within four years at Bir Hospital was made. Patients were divided into those undergoing percutaneous nephrolithotomy for the first time and those who had undergone open renal stone surgery in the past. Preoperative and intraoperative variables were recorded and postoperative stone free status and complications were evaluated. Results: Six hundred and twenty seven patients; out of 691, who had undergone percutaneous nephrolithotomy were included. Demographic variables and stone characteristics were similar in the two study groups. percutaneous nephrolithotomy was found to be statistically similar in the two groups in terms of the number of tracts made (p= 0.1642) and operative time (0.9197). Exit strategies were similar in both groups. Stone free rate was 83.33% in patients undergoing percutaneous nephrolithotomy for first time and 82.08% in those with history of open surgery. Average hospital stay was 3 days in both groups. Although the group with history of previous surgery had significantly more complications (p= 0.0207), Clavien grading was similar in the two groups.Conclusions: This study shows that the rate of complications is more in patients with history of open surgery, most complications are minor, not requiring intensive management. percutaneous nephrolithotomy is efficient and safe in patients with history of open renal stone surgery. Keywords: Complications; open renal stone surgery; percutaneous nephrolithotomy

scholarly journals Management outcomes of ectopic pregnancy depending on different treatment modalities: a cohort study

2021 ◽  
Vol 10 (3) ◽  
pp. 842
Author(s):  
Shawqi H. Alawdi ◽  
Mayada Roumieh ◽  
Marwan Alhalabi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Single Dose ◽  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Expectant Management ◽  
Pelvic Surgery ◽  
Dose Methotrexate ◽  
Significant Difference ◽  
History Of

Background: Ectopic pregnancy is the most common cause of maternal morbidity and mortality during the first trimester of pregnancy. The present study aimed to review and evaluate the management outcomes of ectopic pregnancy in Damascus University Maternity Hospital, Syria.Methods: A retrospective cohort study was performed on women referring to Damascus University Hospital of Obstetrics and Gynecology (OBGYN) for ectopic pregnancy. Patients were assigned into groups by method of treatment: expectant management (Group 1), single-dose methotrexate regimen (Group 2), two-dose methotrexate regimen (Group 3), and surgical intervention (Group 4). Parameters assessed were risk factors for ectopic pregnancies, transvaginal ultrasonography findings, serum human chorionic gonadotropin (hCG) levels on Days 0, 4, 7, and types of surgical intervention in women that underwent any surgical intervention. A treatment modality was considered successful when hCG levels declined to less than 5 mIU/L without further administration of methotrexate dose or need for surgery.Results: Seventy-seven women with ectopic pregnancy were admitted to the hospital during the study period. Groups 1, 2, 3, and 4 constituted 20.8%, 13.0%, 6.5% and 59.7% of the patients respectively. The most common encountered risk factors for ectopic pregnancy in the patients were history of previous intra-abdominal or pelvic surgery (57.1%) and history of miscarriage (41.6%). A statistically significant difference in the serum hCG concentrations measured on day 0, day 4, and day 7 were observed between the groups.Conclusions: The success rate in ectopic pregnancy treatment was 56.25% for the expectant management, 70% for the single-dose methotrexate regimen, and 40% for two-dose methotrexate regimen.

scholarly journals RISK FACTOR OF ECTOPIC PREGNANCY BY USING LITERATURE REVIEW METHOD

2021 ◽  
Vol 5 (3) ◽  
pp. 277
Author(s):  
Winda Fatma Sari ◽  
Adityawarman Adityawarman ◽  
Budiono Budiono
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Literature Review ◽  
Ectopic Pregnancy ◽  
Exclusion Criteria ◽  
Mortality And Morbidity ◽  
Pregnancy History ◽  
Major Predictor ◽  
History Of

Background: Ectopic pregnancy is a pregnancy outside the uterus, embryo could attached to thefallopian tube, ovary cervix or cervix. Around 85-90% incidence of ectopic pregnancy is found inmultigravid women. According to data from the Health Office, maternal mortality in 2017 tendsto increase in the last two years. Not only it is a major predictor of mortality and morbidity inpregnant women, but individuals with a history of ectopic pregnancy have a greater risk. Thepurpose of this research was to determine the risk factors that cause ectopic pregnancy by usingliterature studies review. Method:This study used a systematic review of articles that publishedbetween 2013-2020 in the Science Direct, Scopus and Google Scholar. 10 articles that meet theinclusion and exclusion criteria, included as a sample for further review. The results regarding torisk factors that caused ectopic pregnancy in each article were systematically synthesized. Results:Risk factors found to be significantly associated with the incidence of ectopic pregnancy in thearticle were age (2), infertility (2), IUD (3), PID (3), Ectopic Pregnancy History (5), Progestine Pills (2), History of Abortion (1), Smoking (3). Conclusions: age, infertility, IUD, PID, history of ectopic pregnancy, progestine pill, History of abortion, and smoking were risk factors that hadsignificant relationship with the incidence of ectopic pregnancy.

scholarly journals Successful conservative management of a rare case of ruptured cornual ectopic pregnancy

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Sreelatha S ◽  
Sumayya Sana ◽  
Pruthvi S ◽  
Yashaswini . ◽  
Shruthi K ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Severe Pain ◽  
Hypovolemic Shock ◽  
Medical Emergency ◽  
Emergency Laparotomy ◽  
Cornual Pregnancy ◽  
Rare Type ◽  
Pain Abdomen ◽  
Ectopic Pregnancies ◽  
Period Of Gestation

Cornual pregnancy is a rare type of ectopic pregnancy with incidence of about 2-4% of all ectopic pregnancies. The mortality rate is about 2-2.5%. The diagnosis and management is challenging and frequently constitute a medical emergency. We report a case of a 33year old second gravida, para 1, living 1 with previous LSCS with 13weeks 2days period of gestation presenting to the casualty with complaints of severe pain abdomen and signs of hypovolemic shock. Ultrasound revealed gross hemoperitoneum with ruptured right adnexal gestation. Emergency laparotomy was done and cornual end was found ruptured and was sutured successfully and hemostasis achieved. Intra operative two units of packed cells was transfused. Patient was discharged stable on post-op day 7.

Sign in / Sign up

Export Citation Format

Share Document