scholarly journals Changing Concept in the Management of Ectopic Pregnancy - A Case Report

2018 ◽  
Vol 8 (2) ◽  
pp. 73-75
Author(s):  
Sumana Rahman
Keyword(s):  
Single Dose ◽  
Case Report ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Complete Resolution ◽  
Operative Procedure ◽  
Diagnostic Error ◽  
Conservative Approach ◽  
Tubal Ectopic Pregnancy ◽  
First Time

Ectopic pregnancy remains the great puzzle of gynaecology, no other pelvic condition gives rise to more diagnostic error like this condition. In the last 20 years, the management of ectopic pregnancy has evolved from a radical operative procedure to a more conservative approach. This case report describes a woman who experienced tubal ectopic pregnancy twice, with two different methods of management. In the first time she had left sided ruptured tubal ectopic pregnancy which was managed by laparoscopic left sided salphingectomy. In the next time, her right tube was involved with ectopic pregnancy. This time, she was decided to be managed by conservative medical treatment. The patient was treated with a single dose of injection methotrexate 50 mg intramuscularly. She was monitored closely at 4-5 days interval. At the 19th day, she was found to have complete resolution of the ectopic sac.J Shaheed Suhrawardy Med Coll, December 2016, Vol.8(2); 73-75

scholarly journals Medical Management of Ectopic Pregnancy: An Observational Study

2016 ◽  
Vol 29 (1) ◽  
pp. 32-36
Author(s):  
Shahana Begum ◽  
Rowshan Akhtar
Keyword(s):  
Single Dose ◽  
Observational Study ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Medical Management ◽  
Progesterone Level ◽  
Fertility Treatment ◽  
Intrauterine Pregnancy ◽  
College Hospital ◽  
Serum Progesterone

Objectives: The aim of this study was to explore the safety and efficacy of medical management of ectopic pregnancy.Materials and methods: This prospective observational study was conducted between February 2011 to August 2013 in Chittagong Medical College Hospital (CMCH) and in different private clinics of Chittagong city. Twenty-seven patients of ectopic pregnancy conceived by fertility treatment were recruited for medical treatment after proper evaluation. Ectopic pregnancy was diagnosed by serum ?-hCG and progesterone level but missing intrauterine pregnancy by transabdominal sonography (TAS). Serum ?-hCG was repeated after 48 hours to observe doubling of the level. If level was not doubled or increment was not at least 66% and serum progesterone level was less than 15ng/ml then it was considered as ectopic pregnancy. Patients were treated with Injection methotrexate 50 mg intramuscularly either by single dose or two doses. After 4 days of 1st injection ?-hCG was repeated and if level decreased > 15% then patients were assessed weekly till ?-hCG fell to <5lU/L. If drop was <15% after 4 days a second dose of methotrexate was given.Results: Overall success rate was 66.66% . Surgical intervention was needed in 22.22% patients. All patients were treated after hospitalization in CMCH and different private clinics of Chittagong. They got injection methotrexate, antibiotic, antispasmodic and analgesics for abdominal pain. Single dose cured 55.55% patients and 11.11% patients needed second dose, another 11.11% patients were misdiagnosed –later on they were diagnosed as intrauterine pregnancy and medical termination was done. Within one year of treatment 33.33% patients conceived again. There was no side effect or complications of the treatment.Conclusion: This small trial gave a good impression about medical treatment in selective cases. The efficacy should be assessed in a randomized clinical trial with a different set of populationBangladesh J Obstet Gynaecol, 2014; Vol. 29(1) : 32-36

scholarly journals A case report and a literature review: A challenging case of Chronic tubal ectopic pregnancy

2021 ◽  
Vol 10 (1) ◽  
pp. 5-6
Author(s):  
Nourah Al Kindi ◽  
Fatima Al Shalabi ◽  
Shabana Kapadia ◽  
Asma Jan
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Ectopic Pregnancy ◽  
Tubal Ectopic Pregnancy

scholarly journals Predictors of Success of Repeated Injections of Single-dose Methotrexate Regimen for Tubal Ectopic Pregnancy

2006 ◽  
Vol 21 (1) ◽  
pp. 86 ◽  
Author(s):  
Geum Joon Cho ◽  
Sang Hoon Lee ◽  
Jin Woo Shin ◽  
Nak Woo Lee ◽  
Tak Kim ◽  
...  
Keyword(s):  
Single Dose ◽  
Ectopic Pregnancy ◽  
Predictors Of Success ◽  
Tubal Ectopic Pregnancy ◽  
Dose Methotrexate

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 Cyclical menouria syndrome following mid trimester abortion: a case report

1970 ◽  
Vol 4 (1) ◽  
pp. 49-51
Author(s):  
Pratiksha Gupta ◽  
Anju Huria ◽  
Reeti Mehra ◽  
Usha Dalal
Keyword(s):  
Case Report ◽  
Complete Resolution ◽  
Surgical Repair ◽  
Menstrual Blood ◽  
Trimester Abortion ◽  
Obstetrics And Gynaecology ◽  
June July ◽  
First Time

Menouia is terminology used for the passage of menstrual blood only in the urine and results from supraisthmicuterovesical fistula. Report here, for the first time is a case of cyclical menouria, that developed afterinduced mid trimester abortion in a 26 yrs, P2L2A1 which was diagnosed relatively with ease from history,simple selected investigations who underwent successful surgical repair meaning complete resolution ofcyclic haematuria.Key words: Menouria; uterovesical fistula; induced abortionDOI: 10.3126/njog.v4i1.3333Nepal Journal of Obstetrics and Gynaecology June-July 2009; 4(1): 49-51

scholarly journals Cost-effectiveness analysis of different methods of treatment of tubal ectopic pregnancy in the south of Iran

2020 ◽  
Author(s):  
Bahia Namavar Jahromi ◽  
Elahe esmaili ◽  
Mozhgan Fardid ◽  
Jafari Abdosaleh ◽  
Zahra Kavosi ◽  
...  
Keyword(s):  
Single Dose ◽  
Cost Effectiveness ◽  
Incremental Cost ◽  
Ectopic Pregnancy ◽  
Cost Effective ◽  
Cost Utility ◽  
Double Dose ◽  
Tubal Ectopic Pregnancy ◽  
Dose Methotrexate ◽  
The Cost

Abstract Background: Ectopic pregnancy is one of the most important causes of maternal mortality and infertility that may impose many costs on patients. Today, Surgery and pharmaceutical treatments are the common methods of treating the disease. The aim of this study was to evaluate the cost-effectiveness of different methods of treating tubal ectopic pregnancy in the south of Iran.Methods: This study was an economic evaluation which analysed and compared the cost-effectiveness and cost-utility of three treatment methods, including single-dose methotrexate, double-dose methotrexate, and surgery in patients with tubal ectopic pregnancy. In this study, a decision tree model was used. The outcomes included in the model were the percentage of successful treatment and the average utility score of each treatment method. The study was conducted from the social perspective and a one-way and probabilistic sensitivity analysis was performed to measure the effects of uncertainty. The analysis of the collected data was performed using Excel and TreeAge software.Results: The incremental cost-effectiveness ratio of the surgery versus single-dose methotrexate was positive and equal to $5812 PPP; since it was less than the threshold, surgery was considered as a cost-effective method. The incremental cost-utility ratio also identified surgery as the best option. Moreover, the results of one-way showed the highest sensitivity to the effectiveness of single-dose methotrexate. Scatter plots also revealed that surgery in 82% and 96% of simulations was at the acceptable region compared with a single dose and double-dose methotrexate, respectively and below the threshold. It was identified as a more cost-effective strategy. Furthermore, the acceptability curves showed that in 81.4% of simulations, surgery was the most cost-effective treatment for thresholds less than 21011 PPP dollars.Conclusions: Based on the results of the present study, it is recommended that surgery can be used as the first line of treatment for ectopic. Also, the best drug strategy was single-dose methotrexate. Since these strategies reduce costs and increase treatment success and QALYs compared to double-dose methotrexate.

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