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 ECTOPIC PREGNANCY;

2012 ◽  
Vol 19 (02) ◽  
pp. 242-245
Author(s):  
ROBINA ALI ◽  
Uzma AFZAL
Keyword(s):  
Early Diagnosis ◽  
Medical Treatment ◽  
Ectopic Pregnancy ◽  
Study Design ◽  
Medical Management ◽  
Surgical Intervention ◽  
Resolution Time ◽  
Safe Alternative ◽  
Extrauterine Pregnancy ◽  
Medical College

Objectives: To assess the effectiveness of systemic methotrexate for treatment of unruptured ectopic pregnancy. Introduction:Ectopic Pregnancy is pregnancy that occurs in any location other than the uterus. 95% to 98% are tubal ectopics, but the number of ovarian,abdominal and cervical implantations is rising as does the number of heterotopic pregnancies. Study Design: Prospective experimental study.Setting: DHQ Hospital affiliated with Punjab Medical College Faisalabad. Period: Jan-2009 to Dec-2009. Patient & Method: A total of 45women were admitted with diagnosis of extrauterine pregnancy. But only 10 women fulfilled the criteria for medical management. Out of these80% patients required no surgical intervention. However 20% needed surgery. 60% patients suffered from lower abdominal or pelvic pain. 20%required 2nd dose of methotrexate. Average ß-hCG resolution time was 35 days. Conclusions: With early diagnosis and proper selectioncriteria adoption, medical treatment of ectopic pregnancy with systemic methotrexate is an effective and safe alternative to surgicalinterventions.

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 Role of methotrexate in ectopic pregnancy

2020 ◽  
Vol 10 (1) ◽  
pp. 84
Author(s):  
Munjal J. Pandya ◽  
Neha V. Ninama ◽  
Chirag V. Thummar ◽  
Meet K. Patel
Keyword(s):  
Ectopic Pregnancy ◽  
Success Rate ◽  
Surgical Intervention ◽  
Cost Effective ◽  
First Trimester ◽  
Medical College ◽  
Beta Human Chorionic Gonadotropin ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an acute emergency in obstetric if not timely diagnosed and timely treated. Ectopic pregnancy is leading cause of death in first trimester. Ectopic pregnancy can be managed surgically or medically. Medical management with Methotrexate administration avoids anesthesia in surgery, is cost effective and also offers success rate comparable to surgical management. Aim and objectives were to study the role of methotrexate in ectopic pregnancyMethods: This will be a retrospective observational study conducted in Obstetrics and Gynecology department of AMC MET medical college. Study group constitutes of 30 females with ectopic pregnancy. Preliminary blood investigations, ultrasonography and beta-human chorionic gonadotropin (b-hcg) level will be tested. Patients will be treated with single dose of methotrexate 50 mg/M2. Follow up b-hcg level will be done after 48 hours. Response and tolerance to methotrexate will be monitored.Results: The success rate of methotrexate therapy in our study was 83.33% (n=25) and 16.66% (n=5) required surgical intervention with tubal ruptured and abdominal pain.Conclusions: Methotrexate treatment of ectopic pregnancies is safe and effective with no major side effects. It has the advantage of tubal conservation and saves patients from surgical intervention.

EMERGENCY SURGERY DURING COVID 19 AT K.A.P.V GOVERNMENT MEDICAL COLLEGE AND MGMGH , TRICHY

2021 ◽  
pp. 6-9
Author(s):  
Sumathi Ravikumar ◽  
Yeganathan Rajappan ◽  
Durairajan Vaithiyanathan ◽  
Catherine Sindhuja
Keyword(s):  
Surgical Intervention ◽  
District General Hospital ◽  
Favourable Outcome ◽  
Emergency General Surgery ◽  
Emergency Admissions ◽  
Medical College ◽  
Prolonged Duration ◽  
Current Impact ◽  
Emergency Surgical Intervention ◽  
The Impact

COVID 19 pandemic was declared by WHO as public health emergency on January 30,2020. Health system was reorganised with the aim to cope with the new disease and maintain essential health service. Many patients suffered from ARDS which lead to the modication of clinical and surgical activity. Current impact of COVID 19 outbreak on emergency surgical practice is still not developed. Varied presentation, diagnostic uncertainity, lack of guidelines present challenges to surgeons. AIM: The aim of our study was to evaluate the impact of the COVID-19 pandemic on emergency general surgery admissions and operations in our institution METHODS: We conducted a retrospective study in K.A.P.V.G.M.C. and M.G.M.G.H., Trichy from march 2020 to December 2020. All general surgical emergency admissions to KAPVGMC and MGMGH, district general hospital were included from march to December 2020.The details of diagnosis and subsequent management were retrieved from records. CONCLUSION: It was observed thatclinical decisions were made based on urgency of each case while simultaneously evaluating their COVID 19 status. The number of surgicalcases during COVID 19 period were signicantly reduced. Recognising asymptomatic carriers and need of emergency surgical intervention were the challenges faced by the surgeons. Effective communication between microbiologist, radiologist, anaesthetist and surgeon was necessary to attain a favourable outcome. .Inspite of challenges faced 80% had postoperative uneventful period other than prolonged duration of stay and were discharged and followed up. Covid 19 pneumonia and ARDS attributed to majority of death among the 20 % of deceased , other than septicemia

scholarly journals Clinical study of ectopic pregnancy

2017 ◽  
Vol 6 (8) ◽  
pp. 3498
Author(s):  
Meenakshi T. Chate ◽  
Bhagyashree Chate ◽  
Kranti Chate
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Public Health Issue ◽  
Common Symptom ◽  
Age Group ◽  
Common Site ◽  
Common Risk Factor ◽  
Medical College ◽  
Endometrial Cavity ◽  
Rising Incidence

Background: Ectopic pregnancy is pregnancy that develops following implantation anywhere other than the endometrial cavity of uterus. Objective of present study was to investigate the risk factors, clinical presentation and sites of ectopic pregnancy along with management and assessment of risk of maternal mortality and morbidity.Methods: The study was undertaken at Dr. Shankar Rao Chavhan Government Medical College and Guru Govind singhji hospital, Nanded between December 2012 and May 2014 after obtaining clearance from the Hospital Ethical Committee.Results: Maximum incidence of tubal gestation occurred between the age group of 21-25 years. Greater incidence was noted in multiparous woman. Tubectomy was the most common risk factor seen in 23.65% cases. The most common symptom observed is abdominal pain seen in 92.47% cases. The most common site of ectopic was ampulla seen in 51.61% cases. The most common mode of presentation was rupture seen in 71 cases about 76.35% cases. Unilateral salpingectomy was done in 70 cases about 75.26% cases.Conclusions: Since ectopic pregnancy remains a gynecological catastrophe in countries and a major challenge to the reproductive performance of women worldwide, it should be considered a relevant public health issue. With its rising incidence, which is likely to continue increasing because of the various factors discussed, it is necessary to devise means of early detection and treatment.

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 Diagnostic Clues and Management of ectopic Pregnancy in Sir Salimullah Medical College and Mitford Hospital, Dhaka

2020 ◽  
Vol 33 (1) ◽  
pp. 49-53
Author(s):  
Nazia Islam
Keyword(s):  
Surgical Treatment ◽  
Ectopic Pregnancy ◽  
Expectant Management ◽  
Cross Sectional Study ◽  
Abdominal Pregnancy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Ectopic Pregnancies ◽  
Condition Diagnosis

Background: Ectopic pregnancy is a common clinical condition. Diagnosis and managementof this condition is necessary in due to day practice. Methods: A cross sectional study on ectopic pregnancy was conducted in Sir SalimullahMedical College and Mitford Hospital (SSMC & MH) , Dhaka, with the objective to analyzethe risk factors and assess the results of management with respect to maternal morbidityand mortality of ectopic pregnancy during the last two years. Result: Fifty patients were admitted with ectopic pregnancy from 1st January 2008 to 31stDecember 2010.Frequency of ectopic pregnancy were 1.5% of total 3252 pregnancies. Riskfactors were found in 45% of cases. Surgical treatment were performed in total 43 patients.There was one heterotrophic pregnancy and one case of abdominal pregnancy. Four patientswere given intramuscular Methotrexate and two un-ruptured ectopics resolved spontaneouslyafter by expectant management. Conclusion: Conservative management was an option but surgical treatment was donemore often because of late referrals. Screening of high risk cases, early diagnosis and earlyintervention would reduce the morbidity in ectopic pregnancies. Bangladesh J Obstet Gynaecol, 2018; Vol. 33(1) : 49-53

scholarly journals Should Open Surgery or Conservative Management be the Choice for Treatment of Ectopic Pregnancy during COVID-19 Pandemic in a Resource-Poor Setting? A Case Series from India.

2020 ◽  
Author(s):  
Rahi Pednekar ◽  
Niraj N Mahajan ◽  
Deepika Tirkey ◽  
Geeta Kulkarni ◽  
Ankita Pandey ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Case Series ◽  
Limited Resource ◽  
Fixed Dose ◽  
Resource Poor Setting ◽  
Surgical Smoke ◽  
Medical College ◽  
Resource Setting ◽  
Resource Poor ◽  
Ectopic Pregnancies

Abstract Background: As the COVID-19 pandemic is progressing, it is posing several challenges for management of health emergencies either by direct impact or through the restrictive policies adopted by several nations worldwide. Currently, there is no information on management of ectopic pregnancies associated with COVID-19 in low resource settings. We report the management of three cases of ectopic pregnancies in a limited resource setting and also describe the challenges we faced in managing these cases at a dedicated COVID-19 hospital in India.Case presentation: T.N. Medical College & B.Y.L. Nair Charitable Hospital (NH) received three asymptomatic, RT-PCR confirmed COVID-19 women with ectopic pregnancy (EP). One was caesarean scar pregnancy (CSP), diagnosed on ultrasound and CT examination and managed with multiple fixed dose methotrexate therapy. Other two cases were ruptured EP managed surgically by laparotomy avoiding laparoscopy to reduce the risk of possible viral transmission.Conclusions: Based on our experience, we recommend laparotomy as an option for surgical management of EP in resource poor settings. It is useful for prevention of possible transmission of SARS-CoV-2 infection to healthcare workers from surgical smoke and it is wiser to take a conservative approach in managing EP wherever possible. More studies are needed to completely disregard the possibility of presence of viable SARS-CoV-2 particles in surgical smoke. There is a need to formulate specific guidelines to address the collateral damage.

scholarly journals Magnitude of Abdominal Wound Dehiscence and Associated Factors of Patients Who Underwent Abdominal Operation at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Berhanetsehay Teklewold ◽  
Dut Pioth ◽  
Tadele Dana
Keyword(s):  
Medical Records ◽  
Addis Ababa ◽  
Age Groups ◽  
Wound Dehiscence ◽  
Complete Healing ◽  
Sub Saharan Africa ◽  
Abdominal Wound ◽  
Related Factors ◽  
Medical College ◽  
Abdominal Wound Dehiscence

Background. Abdominal wound dehiscence (AWD) is the separation of different layers of an abdominal wound before complete healing has taken place. It is a major cause of postoperative morbidity and mortality in sub-Saharan Africa including Ethiopia, and little is known about its prevalence and related factors in the study area. Objectives. The aim of this study is to assess the magnitude of abdominal wound dehiscence and related factors on patients operated at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia. Methods. A hospital-based retrospective review of the chart was carried out by using the data covering three years (September 2014–September 2017) period. Data were collected from hospital medical records of sampled patients such as operation room logbooks and individual patient medical records. The collected data were checked for consistency, coded, and entered into SPSS version 20 for data processing and analysis. Descriptive analysis was conducted, and tables and graphs and summary statistics were used to depict data. Results. A total of 41 patients developed abdominal wound dehiscence from among 4137 patients who underwent abdominal laparotomy in the hospital. Among the patients, 51.2% were in the age range of 41 and above with mean age 29.8 (SD = 1.21) and 70.7% of them were male. Abdominal wound dehiscence was more common in emergency patients (90%) and vertical incision was the most common type of incision. Over half (58.5%) of the wound dehiscence occurred within 6–10 postoperative days. The majority (95.2%) of dehisced patients underwent relaparotomy for the management of the wound dehiscence, and 48.8% of them were treated with tension suture during the second operation of abdominal closure. Four of the patients (9.7%) died after the management of the second operation. Conclusion. The current study revealed that the overall magnitude of abdominal wound dehiscence in the study area was 0.99%. Most of the dehiscence has occurred in male patients, and older age groups were highly affected than the younger ones. Emergency admission is the most common form of admission identified in the study, and this signifies appropriate preoperative preparation of patients for an optimal outcome. However, regarding the management outcome, 9.8% of patients died in our study within the institution after the second operation which is the high mortality rate.

scholarly journals Towards the doctrine of ectopic pregnancy

2020 ◽  
Vol 11 (9) ◽  
pp. 1086-1087
Author(s):  
F. Weber
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Intervention ◽  
Ectopic Pregnancies

Martin has long pointed out that ectopic pregnancies are much more common than commonly assumed, and that they can be safely resolved without any surgical intervention. In this article, he cites a case of ectopic pregnancy that is instructive in many ways.

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