scholarly journals Analysis of Ectopic Pregnancy at Paropakar Maternity and Women’s Hospital

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Beemba Shakya
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Medical Records ◽  
Vaginal Bleeding ◽  
Patient Characteristics ◽  
Diagnostic Modality ◽  
The Common ◽  
Ectopic Pregnancies ◽  
Almost All

Aims: To analyze the patients with ectopic pregnancy. Methods: The medical records of 88 ectopic pregnancies at Paropakar Maternity and Women’s Hospital were reviewed from January to July 2020. Data pertaining patient characteristics, age, gravida, risk factors, clinical presentation, diagnostic modality, site of ectopic pregnancy, management and morbidity associated with it were retrieved and was analyzed using SPSS version 16.0. Results: Among 88 ectopic pregnancies, 28% occurred in 30-34 years,65% were multipara, presented abdominal pain (72%), vaginal bleeding (60%) and amenorrhoea (57%); 72% had ampullary ectopic, 60% had ruptured ectopic, 99% underwent surgical management and 41% required blood transfusion. There was no any mortality. Conclusions: Abdominal pain, vaginal bleeding and amenorrhoea were the common presentation. Only 60% had ruptured ectopic pregnancy. Almost all had surgical management.

scholarly journals Ruptured Tubal Ectopic Pregnancy at Fifteen Weeks Gestational Age

2019 ◽  
Vol 3 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Justine Stremick ◽  
Kyle Couperus ◽  
Simeon Ashworth
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Vaginal Bleeding ◽  
First Trimester ◽  
Second Trimester ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Ectopic Pregnancies ◽  
First Trimester Ultrasound

Tubal ectopic pregnancies are commonly diagnosed during the first trimester. Here we present a second-trimester tubal ectopic pregnancy that was previously misdiagnosed as an intrauterine pregnancy on a first-trimester ultrasound. A 39-year-old gravida 1 para 0 woman at 15 weeks gestation presented with 10 days of progressive, severe abdominal pain, along with vaginal bleeding and intermittent vomiting for two months. She was ultimately found to have a ruptured left tubal ectopic pregnancy. Second-trimester ectopic pregnancies carry a significant maternal mortality risk. Even with the use of ultrasound, they are difficult to diagnose and present unique diagnostic challenges.

scholarly journals Comparison of efficacy safety morbidity and complications of conservative and surgical management of ectopic pregnancies in government TD medical college, Alappuzha, Kerala, India

2017 ◽  
Vol 6 (4) ◽  
pp. 1473
Author(s):  
Laila C. Markose ◽  
Sathiamma P. K.
Keyword(s):  
Abdominal Pain ◽  
Hospital Stay ◽  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Medical Management ◽  
Vaginal Bleeding ◽  
Selection Criteria ◽  
Uterine Cavity ◽  
Management Options ◽  
Medical College

Background: Ectopic pregnancy is pregnancy with implantation of fertilized ovum outside the uterine cavity most commonly in the fallopian tube. Objective of the study was to compare the efficacy, safety, morbidity and complications of conservative and surgical management of ectopic pregnancy.Methods: This is a descriptive study at Government Medical College Alappuzha, Kerala, India to analyze safety morbidity efficacy and complications of conservative medical and surgical management of cases of ectopic pregnancy admitted over a period of one year from May 2011 to April 2012. The study group comprised of 81patients with early pregnancy complaining of abdominal pain, vaginal bleeding, amenorrhoea and no intra uterine gestationsonologically. After confirming diagnosis management options included conservative, surgical or medical management with methotrexate as per selection criteria. Maternal morbidity in terms of hospital stay, blood transfusion, side effects of drugs were compared in both groups.Results: Accurate diagnoses of cases were done. Presenting complaints of the study subjects where vaginal bleeding, abdominal pain and amenorrhoea, which was in variably present in all subjects. Laparotomy done in 71.6% case, methotrexate given for 27.2% cases, laparoscopy for 1.2% all without significant morbidity. Two cases of failed medical management had laparotomy in view of tubal rupture.Blood transfusion given for18.4% case.Conclusions: Hospital stay was more in medically managed group. Sticking on to proper selection criteria both methods are safe and effective without any complications or failure.

scholarly journals Incidence and clinical profile of ectopic pregnancies in a tertiary hospital; A two-year Retrospective study

2020 ◽  
Vol 6 (2) ◽  
pp. 6-11
Author(s):  
Sonam Gyamtsho ◽  
Karma Tenzin ◽  
Tshering Choeda ◽  
Karma Lhaden ◽  
Tandin Om
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Inflammatory Disease ◽  
Vaginal Bleeding ◽  
Morbidity And Mortality ◽  
Clinical Presentations ◽  
History Of ◽  
Ectopic Pregnancies

Introduction: Ectopic pregnancy is an emergency and a life-threatening condition which is an important cause of major maternal morbidity and mortality. This study was designed to determine incidence, common identified risk factors, clinical presentations, management, morbidity and mortality due to ectopic pregnancy at the national referral hospital in Thimphu, Bhutan. Methods: This was a retrospective study of all cases of ectopic pregnancies for a period of two years from 1st January 2018 to 31st December 2019. Socio-demographic characteristics, risk factors, clinical presentations, investigations and mode of treatments were extracted. Simple descriptive statistics such as frequencies, percentages, mean and range were utilised. Results: There were 9603 pregnant women admitted for delivery, out of which 122 were ectopic pregnancies. The incidence of ectopic pregnancy was 12.7/1000 pregnancies. Majority of them were in the age group of 21-30 years and 32.69% of the affected were nulliparous. While Pelvic inflammatory disease was seen in 41.35%, 20.19% were unmarried. Abdominal pain, amenorrhea, and vaginal bleeding were the most common symptoms. Among the ectopic pregnancies, 99.5% were diagnosed with ultrasound. A total of 94.23% had undergone surgical intervention, of which only 1% had laparoscopic surgery. No maternal mortality had occurred. Conclusions: Women with past history of pelvic inflammatory disease, previous miscarriage, unmarried, and nulliparous presenting with history of amenorrhea, abdominal pain, vaginal bleeding should be a high index of suspicion for ectopic pregnancy. Timely diagnosis and intervention in the form of surgical or medical management will reduced the morbidity and mortality due to ectopic pregnancy.

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 Ectopic pregnancy managed medically at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2021 ◽  
Vol 14 (3) ◽  
pp. 85-88
Author(s):  
Jok Thikuiy Gang ◽  
Sisay Kirba Kea ◽  
Samson Gebremedhin
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Records ◽  
Selection Criteria ◽  
Surgical Intervention ◽  
Addis Ababa ◽  
Safe Alternative ◽  
Medical College ◽  
Endometrial Cavity ◽  
Emergency Surgical Intervention ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed medically using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of this approach.Methods: This retrospective study was conducted based on medical records of ectopic pregnancies managed medically using methotrexate. The data of women who had unruptured ectopic pregnancy and who were managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included. Data were extracted from patients’ medical records and analysed using SPSS software.Results: During the 5-year period 2015 to 2019, 81 women with unruptured ectopic pregnancy were managed medically using methotrexate with 93.8% (n=76) success. Methotrexate was administered intramuscularly to all patients in either single dose or multiple doses. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There were no fatal complications.Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.

scholarly journals Ruptured Ectopic Pregnancy in the Presence of an Intrauterine Device

2019 ◽  
Vol 3 (1) ◽  
pp. 51-54 ◽  
Author(s):  
Matthew Neth ◽  
Maxwell Thompson ◽  
Courtney Gibson ◽  
John Gullett ◽  
David Pigott
Keyword(s):  
Abdominal Pain ◽  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Female Patient ◽  
Vaginal Bleeding ◽  
Intrauterine Device ◽  
First Trimester ◽  
Equal Protection ◽  
Intrauterine Pregnancy

Ruptured ectopic pregnancy is the leading cause of first trimester maternal mortality. The diagnosis of ectopic pregnancy should always be suspected in patients with abdominal pain, vaginal bleeding or syncope. While the use of an intrauterine device (IUD) markedly reduces the incidence of intrauterine pregnancy, it does not confer equal protection from the risk of ectopic pregnancy. In this report we discuss the case of a female patient who presented with a ruptured ectopic pregnancy and hemoperitoneum despite a correctly positioned IUD.

scholarly journals Use of FloSeal Sealant in the Surgical Management of Tubal Ectopic Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Mara Clapp ◽  
Jaou-Chen Huang
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Thermal Injury ◽  
Tubal Pregnancy ◽  
Effective Alternative ◽  
Intrauterine Pregnancy ◽  
Tubal Ectopic Pregnancy ◽  
Tubal Patency ◽  
Ectopic Pregnancies

Background. Surgery is sometimes required for the management of tubal ectopic pregnancies. Historically, surgeons used electrosurgery to obtain hemostasis. Topical hemostatic sealants, such as FloSeal, may decrease the reliance on electrosurgery and reduce thermal injury to the tissue.Case. A 33-year-old G1 P0 received methotrexate for a right tubal pregnancy. The patient became symptomatic six days later and underwent a laparoscopic right salpingotomy. After multiple unsuccessful attempts to obtain hemostasis with electrocoagulation, FloSeal was used and hemostasis was obtained. Six weeks later, a hysterosalpingogram (HSG) confirmed tubal patency. The patient subsequently had an intrauterine pregnancy.Conclusion. FloSeal helped to achieve hemostasis during a laparoscopic salpingotomy and preserve tubal patency. FloSeal is an effective alternative and adjunct to electrosurgery in the surgical management of tubal pregnancy.

scholarly journals Impact of SARS-Cov-2 on ectopic pregnancies management in the United Kingdom: a multicentre paired observational study

2020 ◽  
Author(s):  
Sophie Platts ◽  
Jeewantha Ranawakagedon ◽  
Reeba Oliver ◽  
Sayantana Das ◽  
Phalguni Kotabagi ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Expectant Management ◽  
Complication Rates ◽  
University Hospitals ◽  
Length Of Treatment ◽  
Hospital Visits ◽  
Ectopic Pregnancies ◽  
The Impact ◽  
Pregnancy Registry

Objective: to describe the impact of COVID-19 on the management of patients with ectopic pregnancy. Design: a multicentre study comparing outcomes from a prospective cohort during the pandemic [Covid-ectopic pregnancy registry (CEPR)] compared to an historical pre-pandemic cohort [non-Covid ectopic pregnancy registry (NCEPR)]. Setting: five London university hospitals. Population and Methods: consecutive patients diagnosed clinically and/or radiologically with ectopic pregnancy (March/2020-Aug/2020) were entered into the CEPR and an exploratory matched analysis was performed comparing results to NCEPR patients (January/2019-June/2019). Main outcome measures: patient demographics, management (expectant, medical and surgical), length of treatment, number of hospital visits (non-surgical management), length of stay (surgical management) and 30-day complications. Results: 341 patients met inclusion: 162 CEPR and 179 NCEPR. A significantly higher percentage of women underwent non-surgical management versus surgical management in the CEPR versus NCEPR (58.6% [95/162] vs 72.6% [130/179]; p= 0.0084]. Amongst patients managed with expectant management the CEPR had a significantly lower mean number of hospital visits compared to NCEPR [3.6 [SD 1.4] vs 13.7 [SD 13.4], p= 0.0053]. Amongst patients managed with medical management, the CEPR had a significantly lower mean number of hospital visits [NCEPR 6.4 [SD 2.3] vs 8.8 [SD 3.9], p= 0.0014]. There was no observed difference in complication rates between cohorts. Conclusion: women were found to undergo significantly higher rates of non-surgical management during COVID-19 first wave vs NCEPR cohort. Women managed non-surgically in CPER cohort were also managed with fewer hospital attendances. This did not lead to an increase in observed complications rates.

scholarly journals An Audit of Management of Ectopic Pregnancy in a Major Tertiary Healthcare Service

2021 ◽  
pp. 1-5
Author(s):  
Krystle Y. Chong ◽  
Yee K. Mak ◽  
Beverley Vollenhoven ◽  
Ben W. Mol
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Medical Management ◽  
Expectant Management ◽  
Tertiary Hospital ◽  
Management Options ◽  
Local Hospital ◽  
Retrospective Audit ◽  
Tertiary Healthcare ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy remains the most common cause of early pregnancy mortality, with management options differing according to clinical presentation and investigations. This audit aims to investigate the indications for medical and surgical management of ectopic pregnancy at a tertiary hospital network, in order to assess variances in practice and adherence to local hospital protocols. Methods: A retrospective audit of the management of women with a diagnosis of ectopic pregnancy was performed over 12 months from July 2018 to June 2019, at three hospitals in the largest healthcare network in Victoria, Australia. Information collected included patient demographics, risk factors for ectopic pregnancy, pathology and radiology results, documented indication for surgery, and any complications of treatment. A subgroup analysis of data was done to investigate changes and deficiency in management of ectopic pregnancy compared to local hospital protocol. Results: Over a 12-month period, 138 women were diagnosed with an ectopic pregnancy, of which 99 (72%) received surgical management and 39 (28%) received medical management. Four women within the medical group were excluded from analysis, one due to loss of follow-up and three patients who were diagnosed with nontubal ectopic pregnancies. About 94% (33/35) of women who received methotrexate were within hospital guidelines for medical management and 91% (32/35) were successfully managed without surgery. All women who received surgical management underwent a salpingectomy and 97% (96/99) had clear indications documented for surgery within local protocol. Conclusion: Overall, the majority of women with ectopic pregnancy were treated according to local guidelines. Expectant management and the option of salpingostomy as a surgical alternative could be considered in the local guidelines. The dissemination of this clinical audit data is aimed at continuing clinical governance and improvements in outcomes.

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