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 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 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 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 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

Twelve Week Ruptured Interstitial Ectopic Pregnancy

2020 ◽  
Vol 1 (1) ◽  
pp. 23-26
Author(s):  
Sadık Kükrer ◽  
Ayfer Pepekal Kukrer ◽  
Eren Haytoğlu ◽  
Erdal Yılmaz
Keyword(s):  
Maternal Mortality ◽  
Ectopic Pregnancy ◽  
Reproductive Age ◽  
Tubal Ectopic Pregnancy ◽  
Mortality And Morbidity ◽  
Life Threatening ◽  
Gestational Sac ◽  
Interstitial Ectopic Pregnancy ◽  
Ectopic Pregnancies ◽  
Related Mortality

Despite advancements in management and diagnosis, ruptured ectopic pregnancy is still a major reason for pregnancy-related mortality and morbidity. 2% of all pregnancies are ectopic pregnancy and interstitial ectopic pregnancy rate is 2-4% among all ectopic pregnancies. We should consider about it as an essential characteristic in each female of reproductive age that presents with the triad of amenorrhoea, unusual vaginal bleeding and abdominal irritation. It ruptures at a more sophisticated stage of gestation when compared with tubal ectopic pregnancy. Bleeding in interstitial ectopic pregnancy rupture is above that other ectopic pregnancies, also its life-threatening. Interstitial ectopic pregnancy rupture is two to five times greater compared to maternal mortality rate than tubal ectopic pregnancy rupture. Developing gestational sac causes uterine disruption and following hemorrhagic shock, resulting in morbidity and mortality. Clinics that aim to reduce maternal mortality should be much more concerned about convenient disclosure of this abnormal pregnancy condition.

scholarly journals Medical management of ectopic pregnancy

2020 ◽  
Vol 9 (9) ◽  
pp. 3809
Author(s):  
Tseten Zangmu Bhutia ◽  
Zigmee Dorjee Tamang ◽  
Goutam Giri
Keyword(s):  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Failure Rate ◽  
Medical Management ◽  
Treatment Options ◽  
First Trimester ◽  
Benign Condition ◽  
Β Hcg ◽  
Ectopic Pregnancies ◽  
Period Of Gestation

Background: Ectopic pregnancy is a commonest cause of maternal morbidity and mortality in the first trimester of pregnancy. Clinical presentation of ectopic pregnancy has changed from life threatening disease to a more benign condition for which nonsurgical treatment options are available with methotrexate administered systemically or locally. The study was done to evaluate the outcome of medical management of ectopic pregnancy with single regimen methotrexate.Methods: A cohort study was conducted over 18 months on 60 unruptured ectopic pregnancies who were treated with methotrexate injection.Results: Out of 60 unruptured ectopic pregnancies, 53 (88.3%) were successfully treated with methotrexate. Failure rate was 11.7% (7/60) patients who underwent laparotomy. Success of medical treatment was dependent on pretreatment β-hCG (≤4102.5 mIU/mL), period of gestation (≤5 weeks), size of gestational sac (≤3 cm) above which the failure rate increases. No correlation was seen between fall of β-hCG from day 4 to 7 and the success rate. Mean time to resolution of β-hCG seen was 4.3±1.25 weeks. Mean duration of hospital stay was 8.85±1.603 days. Single dose regimen of methotrexate was given to all patients and only 1/60 patients required second dose of methotrexate for suboptimal decrease of β-hCG.Conclusions: The result showed that pretreatment β-hCG level and period of gestation were good predictors for success of medical treatment.

scholarly journals Ectopic pregnancy: a life threatening gynaecological emergency

2016 ◽  
Vol 6 (1) ◽  
pp. 117
Author(s):  
Shruti R. Bhoosanoor ◽  
Sujani BK ◽  
. Urvashi ◽  
Gayatri Devi Sivasambu
Keyword(s):  
Ectopic Pregnancy ◽  
Medical Records ◽  
Maternal Morbidity ◽  
Previous History ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Life Threatening ◽  
History Of ◽  
The Mean ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality.Methods: This is a retrospective study of ectopic pregnancies managed at M. S. Ramaiah Medical College and Hospital, Bangalore, India over a period of 1 year from March 2015 to March 2016. The medical records of the patients managed for ectopic pregnancy during the period, under review were retrieved and data were collected from registers. There were 30 cases of ectopic pregnancies over one year.Results: Ectopic pregnancy constituted 3% of all gynecological admissions, and its incidence was 2.5%. The mean age of the patients was 26 ± 2 years, 21 of 30 (70%) had ruptured ectopic pregnancies, and the remaining nine (30%) were unruptured. The commonest (20 of 30, 66.6%) clinical presentation was abdominal pain, and the commonest (9 of 30, 30%) identified risk factor was a previous history of induced abortion.Conclusions: Ectopic pregnancy is a recognized cause of maternal morbidity and mortality and has remained a reproductive health challenge to manage.

scholarly journals A rare case of unruptured tubal ectopic pregnancy at 14 weeks gestation with live foetus in situ and review of literature

2020 ◽  
Vol 10 (1) ◽  
pp. 422
Author(s):  
Jayanta K. Biswas ◽  
Vivek Tewari
Keyword(s):  
Ectopic Pregnancy ◽  
Rare Case ◽  
Average Duration ◽  
Uterine Cavity ◽  
Limited Resources ◽  
Review Of Literature ◽  
Tubal Ectopic Pregnancy ◽  
Life Threatening ◽  
Ectopic Pregnancies

Ectopic pregnancy is a condition, where the fertilized ovum implants anywhere other than normal uterine cavity. It is life threatening emergency condition and it can present in diverse ways. More than 95% of ectopic pregnancies usually occur in fallopian tube, ampulla being commonest site of tubal ectopic pregnancy. Diagnosis with location of pregnancy is usually possible by ultrasonography in 1st trimester. However, in most of the developing countries with limited resources, many women do not undergo ultrasonography and medical examination in early pregnancy, leading to late diagnosis. It may lead to life threatening presentation of ectopic pregnancy. Reported average duration of diagnosis of unruptured tubal ectopic pregnancy is usually between 5 to 9 weeks of gestation. Very rarely tubal ectopic pregnancy can remain asymptomatic and unruptured for longer than this usual period of gestation. The reported case is a rare case of viable, unruptured tubal ampullary ectopic pregnancy of 14 weeks of gestational age.

scholarly journals Ruptured Unilateral Twin Tubal Ectopic Pregnancy. Case Report of an oddity & Literature Review

2020 ◽  
Vol 1 (1) ◽  
pp. 60-63
Author(s):  
Palwasha Gul ◽  
Khanda Gul ◽  
Pari Gul ◽  
Tanzila Parveen
Keyword(s):  
Ectopic Pregnancy ◽  
Transvaginal Ultrasound ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Maternal Deaths ◽  
Tubal Ectopic Pregnancy ◽  
Beta Hcg ◽  
Ectopic Pregnancies

Background: An ectopic pregnancy (EP) is a type of conception in which, the fertilized egg is lodged outside the uterine cavity. Twin ectopic pregnancies are a rarity, and the reported cases of twin tubal pregnancies are a handful to date.Case Report: We report a case of a 35 years old patient who presented to the emergency with the complaint of lower abdominal pain and intermittent vaginal discharge. She was diagnosed with twin tubal alive gestation, underwent exploratory laparotomy and right salpingectomy.Conclusion: Ectopic pregnancy can occur even in the absence of known risk factors. Its incidence is on the rise. It is a leading cause of first-trimester maternal deaths and can be easily diagnosed with Beta HCG levels and transvaginal ultrasound.

scholarly journals Laparoscopic Management of Ectopic Pregnancy at Birat Medical College & Teaching Hospital, Morang, Nepal

2017 ◽  
Vol 2 (1) ◽  
pp. 106-109
Author(s):  
Bhanubhakta Neupane ◽  
GMS Karki ◽  
P Dahal ◽  
SB Karki
Keyword(s):  
Ectopic Pregnancy ◽  
Teaching Hospital ◽  
College Teaching ◽  
First Trimester ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Laparoscopic Management ◽  
Medical College ◽  
Life Threatening ◽  
Ectopic Pregnancies

IntroductionEctopic pregnancy is the most life threatening emergency in first trimester of pregnancy. Laparoscopic methods for treating ectopic pregnancy have made it preferred surgical technique over laparotomy. Most of the ectopic pregnancies can now be treated by laparoscopy.ObjectiveTo study outcome of laparoscopic management of ectopic pregnancy. MethodologyA hospital based cross-sectional study was conducted at Birat Medical College and Teaching hospital from May 2013 to April 2016. The informed consent was taken from patients. The collected data was entered in Microsoft Excel and analyzed SPSS.ResultsAll 89 cases of ectopic pregnancies were managed by laparoscopy. All were tubal pregnancies. Salpingectomy was done in 88 cases and salpingostomy in one case without any significant postoperative complications. There was no maternal mortality and no conversion to laparotomy  ConclusionTreatment of ectopic pregnancy by laparoscopy is effective with decreased postoperative morbidity.Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, page: 106-109

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