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 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

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 retrospective study of ectopic pregnancy at a tertiary care centre

2017 ◽  
Vol 6 (12) ◽  
pp. 5241 ◽  
Author(s):  
Archana Mehta ◽  
Shehla Jamal ◽  
Neerja Goel ◽  
Mayuri Ahuja
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Fetal Loss ◽  
Tubal Pregnancy ◽  
Tertiary Care Centre ◽  
Future Fertility ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is a global problem and is the most common life-threatening emergency in early pregnancy leading to significant morbidity and fetal loss. It occurs in variable presentations. The rate of ectopic pregnancies has increased from 0.5% in 1970 to 2% today. The aim of this study was to determine the incidence, clinical presentation, risk factors, treatment, and morbidity and mortality associated with ectopic pregnancy.Methods: The present retrospective study was conducted over a period of three years in the department of obstetrics and gynecology at SMS and R, Greater Noida, UP from Feb 2014 to Jan 2017.A total of 80 patients with ectopic pregnancy were analyzed regarding clinical presentation, risk factors, operative findings and treatment modality.Results: Total number of 80 cases of ectopic pregnancies were admitted during this period against 2645 deliveries representing frequency of 3%. Majority of cases (43.75%) were in the age group of 25-29 years and 41.25% were gravida 4 and above. Risk factors were identifiable in 66.25% of cases. Previous abortion was the most common risk factor (31.25%). The classical triad of amenorrhea, pain abdomen and vaginal bleeding was present in 71.25% of cases. More than half of case (55%) had ruptured tubal pregnancy on admission. Unruptured tubal pregnancy was seen in 10% case. Interestingly we found one rare case of bilateral ectopic pregnancy. Salpingectomy by open method was the mainstay of treatment (86.25%).Conclusions: Ectopic pregnancy is still a major challenge in gynecological practice. In our country most of the cases present late after tubal rupture requiring radical surgical treatment. Early diagnosis and timely intervention in the form of medical treatment or conservative surgery not only reduces maternal morbidity but also preserves future fertility.

scholarly journals A Clinical Study of Ectopic Pregnancies in a Tertiary Care Hospital of Chittagong, Bangladesh

2014 ◽  
Vol 13 (3) ◽  
pp. 1-4 ◽  
Author(s):  
Most. Sabina Yeasmin ◽  
M Jalal Uddin ◽  
Enamul Hasan
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Ectopic Pregnancy ◽  
Gestational Age ◽  
Clinical Presentation ◽  
Inflammatory Diseases ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
Care Hospital ◽  
History Of

Background: Motherhood, an eternal, universal and inherent dream which every woman has. This dream may not always be pleasant and it can involve nightmares. One of this is ectopic pregnancy: A pregnancy which can be life threatening. Aims : 1. To know the age group, parity, gestational age and the risk factors with re-spect to the ectopic pregnancy. 2. To know the clinical presentation of the ectopic pregnancy. 3. To know the treatment and morbidity and mortality associated with ectopic pregnancy.Materials & methods : A total of 47 admitted patients who were di-agnosed as ectopic pregnancy cases were retrospective analyzed between the periods from January 2013 to June 2014 at Chattagram Maa-O-Shishu Hospital Medical College, Agrabad, Chittagong. The following parameters: age, parity, gestational age, risk factors, clinical presentation, need for blood transfusion and findings on ultrasonogram and at surgery and morbidity associated with ectopic pregnancy were noted.Results: The incidence of the ectopic pregnancy in the pres-ent study was 7.4/1000 deliveries. A majority of the cases were multigravidas and majority of the cases gestational age were six to ten weeks. In most of the cases, there were no identifiable risk factors. The commonest risk factors present were history of MR (12.7 %)and abortion (10.6), history of tubal surgery (2.2%), infertility (2.2%) and pelvic inflammatory diseases (4.2%).The commonest symptoms were abdominal pain (89.3%), amenorrhea (78.7%) and abnormal vaginal bleeding (63.5%); and commonest signs were abdominal tenderness (70.5%), cervical excitation (52.6%) and adnexal tenderness (50.4%). Almost half (45%) were in a state of shock at admission. Ultrasound, a urine pregnancy test and serum B-hCG were the investigative modalities which were used. Surgery by open method in the form of salpingectomy (92.3%), salpingo-oophorectomy (5.5%) and salpingostomy (2.1%) were the mainstay of management. Morbidity included anemia (50.9%), blood transfusion (78%) and wound infection (2.1%). No maternal mortality noted.Conclusion: Early diagnosis, identifying of underlying risk factors and timely intervention in the form of conservative or surgical treatment will help in reducing the morbidity and mortality associated with ectopic pregnancy.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i3.20993  

scholarly journals Study of ectopic pregnancy in a tertiary care centre

2019 ◽  
Vol 9 (1) ◽  
pp. 212
Author(s):  
Nitesh Meena ◽  
Radheshyam Bairwa ◽  
Savitri Sharma
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Tertiary Care Centre ◽  
Presenting Symptoms ◽  
Mortality Incidence ◽  
Ectopic Pregnancies ◽  
The Right

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. Incidence of ectopic pregnancies has been increasing in last two to three decades with reduction in mortality. The presenting symptoms include irregular vaginal bleeding. The present study was undertaken to study the clinical features of ectopic pregnancies in a tertiary care hospital.Methods: The present study on ectopic pregnancies was carried out in department of obstetrics and gynaecology, jhalawar medical college, Jhalawar, Rajasthan, India from January 2019 to October 2019. All patients admitted with diagnosis of ectopic pregnancy, either ruptured or unruptured where included in the study.Results: Total 52 patient of ectopic pregnancy were studies. Majority (63.46%) of patients belong to the age group 21-30 years. Ectopic pregnancy was most commonly noted in nulliparous woman (44.23%) Majority of the case (31%) had no risk factors among remaining (34.61%), previous MTP (17%), (17-30%) previous ectopic (9%) and PID (15-38%) were identified risk factors. Ampulla (75%) was the most common site for ectopic pregnancy. 57% of the cases were on the right side. The common presenting complaints were pain in abdomen (81%) bleeding/ spotting per vaginal (42%). There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital screening of high-risk case, early diagnosis and early intervention reduce the morbidity and mortality in ectopic pregnancies.

scholarly journals Analysis of various types of ectopic pregnancies: a five-year review

2018 ◽  
Vol 7 (6) ◽  
pp. 2410
Author(s):  
Maheswari S. ◽  
Poornima C. ◽  
Lalitha N. ◽  
Seetha Panicker
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
First Trimester ◽  
Reproductive Age ◽  
Morbidity And Mortality ◽  
Pelvic Surgery ◽  
Main Role ◽  
Contraceptive Device ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy (EP) is a common, life threatening emergency during the first trimester and a significant cause for maternal morbidity and mortality. In any woman of reproductive age presenting with abdominal pain and vaginal bleeding, ectopic pregnancy should be considered. The objectives of the present study is to determine the incidence, risk factors, clinical presentation, type of ectopic pregnancy, treatment, morbidity and mortality.Methods: Retrospective analysis of case sheets of patients admitted with ectopic pregnancy at PSGIMSR, Coimbatore during the period July 2011 to June 2016 was done. The details noted were age, parity, risk factors {previous abortion, previous EP, previous pelvic surgery, intrauterine contraceptive device, tubectomy, history of pelvic inflammatory disease}, treatment for infertility, clinical presentation, ultrasound findings, investigations including beta HCG value and hemoglobin level, treatment offered, need for blood transfusion, operative findings and morbidity.Results: During the five year, there were 12,407 deliveries at our hospitals and 88 cases of ectopic pregnancies were managed. The incidence is 6.6/1000 deliveries. Among them 44% belonged to the age group of 25-30 years and multi gravida were 73.8%. Most common risk factors were previous abortion (23.8%) and previous surgeries including caesarean section, tubectomy, appendicectomy, tubal microsurgery (23.8%). Most common presentation was pain abdomen (85.2%). Out of the 88 cases, 73 patients were managed surgically (82.9%) and 11 cases were managed successfully with methotrexate (12.5%). Three of them underwent conservative management and one had Uterine Artery Embolization.Conclusions: Early diagnosis based on risk factors and timely intervention plays a main role in reducing morbidity and mortality associated with ectopic pregnancy.

scholarly journals An analysis of tubal ectopic pregnancy in a rural tertiary care hospital in India: a retrospective study

2019 ◽  
Vol 8 (9) ◽  
pp. 3466
Author(s):  
Chandana Galidevara ◽  
Swaramya C.
Keyword(s):  
Risk Factors ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Care Hospital ◽  
Common Procedure ◽  
Tubal Ectopic Pregnancy ◽  
Retrospective Data Analysis ◽  
History Of ◽  
Wound Discharge ◽  
Ectopic Pregnancies

Background: The objective of this study was to analyse distribution of predisposing risk factors for ectopic pregnancy and to study the various modalities of management instituted along with surgical characteristics.Methods: This is a retrospective data analysis of tubal ectopic pregnancies (EP) managed in a tertiary rural referral centre over three years.Results: A total of 160 women were managed for tubal EP. Majority of the women belonged to the age group of 21-30 years (73%). Multigravidae constituted 71.3% of the women and overall, 90.6% women conceived spontaneously. History of ovulation induction was present in 3.7% of women, IUI in 1.2% and IVF in 4.4%. Risk factors encountered in the study include previous EP (9.4%), history of tubal sterilisation (6.9%), caesarean section (13.1%), PID (7.5%), miscarriage (25%), tubal recanalization (3.7%). Conservative management was instituted in 16.8%. Amongst the women managed surgically, 67.5% underwent laparotomy with the remaining being managed laparoscopically. Of the surgically managed patients 72.9% had ruptured EP. There was a predominance of right sided ectopic in our study (79%) and ampullary region of the fallopian tube was the most common site of tubal EP (81.2%). The most common procedure performed was total salpingectomy (56.4%). Supportive treatment with blood transfusion was required amongst 18.8% of the women who had EP. In the postoperative period, fever was noted in 13.5% of women and 2.5% needed intensive care unit admission for hemodynamic stabilisation. The incidence of wound discharge was 12% of women who underwent surgery.Conclusions: This study underpins the importance of early diagnosis, appropriate clinical managementwith timely intervention to improve outcomes associated with EP and to prevent severe morbidity and mortality.

scholarly journals A clinical study of ectopic pregnancy in a tertiary care centre in Central India

2017 ◽  
Vol 6 (6) ◽  
pp. 2485
Author(s):  
Mridula Shrivastava ◽  
Hemlata Parashar ◽  
Jyoti Nath Modi
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Ectopic Pregnancy ◽  
Tertiary Care ◽  
Central India ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Tertiary Care Centre ◽  
Presenting Symptoms ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. The incidence of ectopic pregnancy is on a rise globally. Risk factors and causes for ectopic pregnancy may vary with the setting and geographically.Methods: A retrospective analysis of all operated ectopic pregnancies over a 5-year period; between June 2011 to May 2016, was done. Surgically confirmed cases were included in this study and a detailed analysis of presenting symptoms, age, parity and high risk factors was carried out.Results: A total of 50 patients were operated for ectopic pregnancy at our hospital during the study period. Analysis was done for 47 of these due to incomplete data for 3 patients. Majority (62%) of patients belonged to the age group 20-29 years and were gravida 3 and above. Ninety two percent were ruptured ectopic. Sixty two percent ectopic pregnancies were on right side. The common presenting complaints were pain in abdomen (81%) and bleeding/spotting per vaginum (43%). The mean duration between onset of symptoms and reporting to hospital was one and a half day and the average time between admission to hospital and surgery was 9 hours. The ectopic pregnancies were managed surgically in all cases. No obvious risk factors were identified in 34% patients. Among the remaining, previous MTP (17%), previous ectopic (9%) and PID (7%) were identified risk factors. There was no mortality.Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital. Screening of high risk cases, early diagnosis and early intervention reduces the morbidity and mortality in ectopic pregnancies.

Bilateral Simultaneous Isthmic Ectopic Pregnancy After Clomiphene Induction

Folia Medica ◽  
2012 ◽  
Vol 54 (4) ◽  
pp. 78-79 ◽  
Author(s):  
Blagovest K. Pehlivanov ◽  
Georgi I. Amaliev ◽  
Maria L. Malinova ◽  
Ilia G. Amaliev
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Rare Case ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Induction Of Ovulation ◽  
Primary Infertility ◽  
Mild Abdominal Pain ◽  
History Of

Abstract A rare case of a 32-year-old patient with simultaneous bilateral isthmic tubal pregnancy. A 32-year-old woman with a 3-year history of primary infertility was admitted with light vaginal bleeding and mild abdominal pain. She was 41 days after her last menstruation and 23 day after intrauterine insemination with her husband’s sperm. Clomiphene citrate (CC) was used for the induction of ovulation. In cases of ectopic pregnancy with ovulation induced by CC, doctors must be aware of the possibility of bilaterality.

scholarly journals A retrospective study to assess incidence of ectopic pregnancies in Saveetha Medical College and Hospital

2020 ◽  
Vol 9 (11) ◽  
pp. 4632
Author(s):  
S. K. Dheepthikaa ◽  
Rajalekshmi Murugan
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Ectopic Pregnancy ◽  
Ovulation Induction ◽  
Case Fatality ◽  
Safe Abortion ◽  
Oral Contraceptive Pills ◽  
Abdominal Emergency ◽  
Contraceptive Devices ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy is an acute abdominal emergency causing maternal morbidity and mortality. The overall incidence of ectopic pregnancy is increasing in recent times but due to early diagnosis and management the case fatality rate has reduced. Aim of the study is to determine the incidence of ectopic pregnancies in Saveetha hospital and find out common risk factors.Methods: A retrospective study was conducted by analysing the medical records of the patients admitted in the Department of Obstetrics and Gynaecology for 4 years from January 2015 to 2019 at Saveetha hospital, Chennai. The number of ectopic pregnancies out of the total pregnancies and the risk factors causing the ectopic pregnancies were analysed based on case sheets by simple descriptive statistics and percentage method.Result: Incidence was 3% or 30/1000 deliveries. The common age group was between 18 to 38 years. Mean age of ectopic pregnancy was 27.42 years. Risk factors were tubal ligation surgeries- 39.3%, Intrauterine contraceptive devices (IUCD)-19.6%, Pelvic inflammatory disease (PID)-16.1%, infertility and ovulation induction-10.7%, previous ectopic pregnancy and use of Oral contraceptive pills (OCP)-5.4% and previous induced abortions-3.6%.Conclusion: Incidence of ectopic pregnancy is still remaining on the significant numbers. It can be diagnosed early by keeping a high index of suspicion. Tubectomy and other surgeries should be done with proper care. Education regarding safe abortion, unsupervised usage of OCP and risk of ovulation induction to avoid ectopic pregnancies.

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