scholarly journals Case Report on Post Operative Case of Exploratory Laparotomy for Ruptured Ectopic Pregnancy with Septicemia

2021 ◽  
pp. 363-368
Author(s):  
Arati Raut ◽  
Ruchira Ankar ◽  
Samruddhi Gujar ◽  
Savita Pohekar ◽  
Sheetal Sakharkar
Keyword(s):  
Ectopic Pregnancy ◽  
Vaginal Bleeding ◽  
Therapy Monitoring ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Therapeutic Interventions ◽  
Fluid Replacement ◽  
Abdominal Girth ◽  
Operative Case ◽  
Chief Complaints

Introduction: Extra uterine pregnancy is a first-trimester pregnancy problem that affects 1.3–2.4 percent of all pregnancies. The key signs of the ectopic pregnancy are abdominal discomfort and vaginal bleeding along with Sharp, dull, or cramping pains may be experienced around 50% of the women who are suffering from ectopic pregnancy. The neglected ectopic pregnancy may results in the fallopian tube can burst, internal abdominal bleeding, shock, and serious blood loss and later complication is septicemia. As a health care professional it’s very important to manage certain complication with medical and surgical management. Main Symptoms and/or Important Clinical Findings: A 20 years old female with post operative case of Exploratory Laparotomy admitted in A.V.B.R.H. on 14/02/2021.with chief complaints of the after undergone certain investigation she  has diagnosed as Exploratory Laparotomy with septicemia as post-op complication. The Main Diagnoses, Therapeutic Interventions, and Outcomes: A 20 years old female with post-operative Exploratory Laparotomy for Ruptured Ectopic Pregnancy operated case with septicemia, with chief complaints of acute abdominal pain, and vaginal bleeding the doctors manage her initially with I.V. fluids, antibiotics, Zonac suppository and adequate nursing management. Nursing Perspectives: The nursing interventions initiated for managing present case are fluid replacement therapy, monitoring vital sign per hourly, monitoring the CBC reports and other investigations like USG abdomen, blood glucose levels. Maintained TPR Chart, I/O Charting, abdominal girth charting. Conclusion: In the Present case the patient of A  20 year old female with post operative exploratory laparotomy  for  ruptured ectopic pregnancy with  septicemia it has been managed with  the therapeutic and surgical   treatment ,right now the patient condition then  patient has discharged on dated 22/2/21.

scholarly journals Case Report Postoperative Case of Explore Laparotomy for Ruptured Ectopic Pregnancy with Septicemia

2021 ◽  
pp. 270-274
Author(s):  
Minakshi Choudhary ◽  
Akhtaribano Sayyad ◽  
Seema Yelne ◽  
Sagar Bhovare ◽  
Deepesh Choudhary ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Ectopic Pregnancy ◽  
Pain Treatment ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Clinical Findings ◽  
Therapeutic Interventions ◽  
Excessive Bleeding ◽  
Operative Case ◽  
Diagnostic Ultrasonography

Introduction: Ectopic pregnancy is a pregnancy problem when the embryo attaches itself outside the uterus. Signs and symptoms include abdominal pain and vaginal bleeding, but less than 50 percent of affected women have both. it happened. Excessive bleeding may lead to a rapid heartbeat, fainting, or panic attack. Without abnormalities, the fetus can no longer survive. Obstetricians and gynaecologists face various obstacles in dealing with Jehovah's Witnesses. Main Symptoms and/or Important Clinical Findings: A 20-year-old man with a post-operative case of Explore Laparotomy For Ruptured Ectopic Pregnancy with pyosalpinx with septicemia underwent surgery on 14/02/2021 investigating Laparotomy under GA. His diagnostic ultrasonography was performed. Complete the blood test. She had not dropped down before 8 days she was a primigravida at 2 months of pregnancy and then had abdominal pain as she grew stronger over time. The Main Diagnoses, Therapeutic Interventions, and Outcomes: A 20-year-old man with a post-operative case of Explore Laparotomy for Ruptured Ectopic Pregnancy with pyosalpinx withsepticemia, with a complaint of abdominal pain, Treatment began on the day he received V fluids, Antibiotics Injectable. Initiated, Zonac suppository PR consulted. TPR Charting treatment interventions, I / O Charting, abortion chart, Nursing Perspectives: Laboratory techniques are urgently required. To limit the development of treatments to enhance the outcome. Conclusion: Although it is not uncommon for an ectopic pregnancy to exceed the first trimester, it does occur occasionally. As a result, in any emergency, abdominal surgery during pregnancy, Today, early intervention saves lives and reduces morbidity, but ectopic pregnancy still kills 4 to 10% of pregnant women and results in a higher ectopic pregnancy rate following pregnancy.

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 Different Sonographic Faces of Ectopic Pregnancy

2017 ◽  
Vol 7 ◽  
pp. 6 ◽  
Author(s):  
Charu Chanana ◽  
Nishant Gupta ◽  
Itisha Bansal ◽  
Kusum Hooda ◽  
Pranav Sharma ◽  
...  
Keyword(s):  
Ectopic Pregnancy ◽  
Chorionic Gonadotropin ◽  
Vaginal Bleeding ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
First Trimester ◽  
Intrauterine Pregnancy ◽  
Pictorial Essay ◽  
History Of ◽  
Clinical Signs And Symptoms

Vaginal bleeding in the first trimester has wide differential diagnoses, the most common being a normal early intrauterine pregnancy, with other potential causes including spontaneous abortion and ectopic pregnancy. The incidence of ectopic pregnancy is approximately 2% of all reported pregnancies and is one of the leading causes of maternal mortality worldwide. Clinical signs and symptoms of ectopic pregnancy are often nonspecific. History of pelvic pain with bleeding and positive β-human chorionic gonadotropin should raise the possibility of ectopic pregnancy. Knowledge of the different locations of ectopic pregnancy is of utmost importance, in which ultrasound imaging plays a crucial role. This pictorial essay depicts sonographic findings and essential pitfalls in diagnosing ectopic pregnancy.

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 Clinical study of role of ultrasound in first trimester vaginal bleeding

2020 ◽  
Vol 9 (10) ◽  
pp. 4010
Author(s):  
Sandyashree P. K. ◽  
Swathi Nayak C. V.
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Diagnosis ◽  
Vaginal Bleeding ◽  
Correct Diagnosis ◽  
Cost Effective ◽  
First Trimester ◽  
Statistical Correlation ◽  
Ultrasound Diagnosis ◽  
General Physical ◽  
Sensitivity Specificity

Background: Vaginal bleeding is a serious cause which needs an emergency consultation. Major causes are abortion, ectopic pregnancy and molar pregnancy others like cervical erosion, polyp and carcinoma. The objective is to identify cause, assess the prognosis and institute appropriate management.Methods: Prospective study in MMC and RI, OBG, Mysore from November 2015 to September 2017. General physical and pelvic examination done for provisional clinical diagnosis and subjected to Ultrasound. Clinical diagnosis and ultrasound diagnosis were correlated.Results: 100 cases of first trimester bleeding evaluated by Ultrasonography with an incidence 2.37%. Most common cause was abortion (81.6%) then molar (10%) and ectopic pregnancy (9%). Out of 100 cases, 72 cases confirmed, 28 cases proved by ultrasound which was misdiagnosed on clinical examination with disparity of 72 between clinical and ultrasound diagnosis. 13 cases viable pregnancy by ultrasonography with sensitivity, specificity, NPV and PPV of 100% and 69 cases nonviable pregnancies with sensitivity, specificity and NPV of 100%. 9 cases ectopic pregnancy were diagnosed on ultrasound with sensitivity 100%, specificity 98.9%, PPV 99% and accuracy 99%. Clinical diagnosis in diagnosing viable pregnancies has sensitivity 76.92%, specificity 64.36% and PPV 24.39%. In diagnosis nonviable pregnancies, clinical diagnosis, poor statistical correlation with sensitivity 77.58, specificity 83.33%, PPV 86.53% and NPV 72.91%. Ultrasonographic diagnosis proved as very accurate on statistical correlation.Conclusions: Ultrasound is sensitive, cost effective and non-invasive diagnostic tool in first trimester bleeding. In this study, it helped in correct diagnosis of clinically misdiagnosed cases apart from confirming the diagnosis in others.

scholarly journals A Molar Pregnancy within the Fallopian Tube

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Laura Allen ◽  
Charlotte Dawson ◽  
Patricia Nascu ◽  
Tyler Rouse
Keyword(s):  
Ectopic Pregnancy ◽  
Fallopian Tube ◽  
Spontaneous Abortion ◽  
Postoperative Care ◽  
Vaginal Bleeding ◽  
Adnexal Mass ◽  
First Trimester ◽  
Molar Pregnancy ◽  
Rare Occurrence

Background. Discussion of the incidence of molar pregnancy and ectopic pregnancy. Role of salpingostomy and special considerations for postoperative care.Case. The patient is a 29-year-old G7P4 who presented with vaginal bleeding in the first trimester and was initially thought to have a spontaneous abortion. Ultrasound was performed due to ongoing symptoms and an adnexal mass was noted. She underwent uncomplicated salpingostomy and was later found to have a partial molar ectopic pregnancy.Conclusion. This case illustrates the rare occurrence of a molar ectopic pregnancy. There was no indication of molar pregnancy preoperatively and this case highlights the importance of submitting and reviewing pathological specimens.

scholarly journals Current pattern of presentation and approach to the management of ectopic gestation in the state specialist hospital Ondo: a two-year review

2017 ◽  
Vol 5 (10) ◽  
pp. 4242
Author(s):  
Adedokun I. Adegoke
Keyword(s):  
Abdominal Pain ◽  
Vaginal Bleeding ◽  
Exploratory Laparotomy ◽  
First Trimester ◽  
Current Pattern ◽  
Case Record ◽  
Ectopic Gestation ◽  
The World ◽  
Sub Saharan ◽  
The Right

Background: Ectopic gestation is still the leading cause of pregnancy related death in the first trimester. Not much has changed in the area of management in the developing world due to the pattern of patients’ presentation and paucity of laparoscopic facilities. The study aims to assess the current pattern of presentation and approach to the management of ectopic gestation in a secondary health facility in sub-Saharan Africa.Methods: A retrospective study was carried out to assess the current pattern of patients’ presentation and approach to management of ectopic gestation in State Specialist Hospital, Ondo, Nigeria. All the data were retrieved from the case record of patients and analysed using SPSS version 20.Result: The commonest symptoms patients presented with were abdominal pain, amenorrhoea and vaginal bleeding with figures 63 (96.92%), 47 (72.31%) and 34 (52.31%) respectively. Tubal ectopic gestation was the commonest type found in 60 (92.31%) patients and was more on the right (56.92%). Fifty-nine (90.77%) of the tubal ectopic gestations were ruptured while only one was unruptured. All the patients had exploratory laparotomy. No mortality was recorded during the period under review.Conclusion: All the patients reviewed had exploratory laparotomy mainly due to the non-availability of laparoscopy in our centre, the nature of presentation and the financial capability of the patients and their relations. These factors still remain the determinants of clinician’s choice of patients’ management in low resource settings of the world.

scholarly journals NICE guideline “Ectopic pregnancy and miscarriage”: new changes and importance for the clinicist

2021 ◽  
pp. 48-52
Author(s):  
- -
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Guidelines ◽  
Vaginal Bleeding ◽  
Recurrent Miscarriage ◽  
First Trimester ◽  
Current Data ◽  
Nice Guideline ◽  
Threatened Miscarriage ◽  
Patients At Risk ◽  
First Trimester Of Pregnancy

The purpose of this publication is to summarize the current data on the effectiveness of progestogens in patients with threatened miscarriage (vaginal bleeding in the first trimester of pregnancy) and to review the updated UK National Institute for Health and Care Excel (NICE) clinical guidelines on ectopic pregnancy and miscarriage.In accordance with the opinion of the Cochrane Society experts and the updated NICE clinical guidelines for 2021, vaginal progesterone at a dose of 800 mg/day is the only intervention that has been shown to be effective in increasing live births compared to placebo for women with one or more previous miscarriages and early vaginal bleeding (relative risk 1.08, 95% confidence interval 1.02–1.15, high certainty evidence). Upon confirmation of fetal heartbeat, this treatment should be extended until 16 weeks of gestation.There is still uncertainty over the effectiveness and safety of alternative progestogen treatments (as dydrogesterone) for threatened and recurrent miscarriage. There is also no evidence of benefit of any other preparations or doses of progesterone in patients at risk of miscarriage.

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 Management and Outcomes of Pregnancy with Gestational Hypertension and Hyperthyroidism: A Case Report

2021 ◽  
pp. 295-299
Author(s):  
Arundhatee Dagadkar
Keyword(s):  
Thyroid Hormone ◽  
Caesarean Section ◽  
Physical Examination ◽  
Gestational Hypertension ◽  
Vital Signs ◽  
Fetal Monitoring ◽  
First Trimester ◽  
Therapeutic Interventions ◽  
Fluid Replacement ◽  
Obstetric History

Introduction: Hyperthyroidism associated increases in thyroid hormone concentrations have to be differentiated from physiological adjustments in thyroid hormone economic system that rise up all through being pregnant, especially in the first trimester. For one thousand births, one or two instances of gestational hyperthyroidism exist. It's critical to stumble on hyperthyroidism in a pregnant female due to the fact it is able to have harmful outcomes for each the mom and the infant. Presenting Complaint and Investigations: Patient’s chief complaints were vomiting, discomfort since 2 days. After physical examination and investigations, doctor diagnosed this as case of G2A1 with 35 weeks gestational age. This was a known case of gestational hypertension with hyperthyroidism. Investigations included Blood test, urine test, thyroid Profile, USG. Obstetric History: Patient had bad obstetric history. 2.5 months spontaneous abortion was reported. The Main Diagnoses, Therapeutic Interventions, and Outcomes: Gestational Hypertension with Known case of Hyperthyroidism. The patient had undergone various investigations like blood tests, USG, Physical examination. After physical examination and investigation doctor took a decision of emergency Lower segmental Caesarean section. Under spinal anaesthesia Lower segmental Caesarean section was done and outcome is good. Nursing Perspectives: Administered fluid replacement i.e. DNS and RL, Fetal monitoring, monitored all vital signs and observed the outcomes of treatment. Conclusion: Treatment and control of hypertension and hyperthyroidism in pregnancy at the right time increases the pregnancy's outcome.

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