Analysis of ectopic pregnancies admitted to emergency department (original) (raw)

Ruptured ectopic pregnancy: risk factors for a life-threatening condition

Archives of Gynecology and Obstetrics, 2009

Introduction Ectopic pregnancy is a signiWcant cause of maternal morbidity and mortality. The widely used features to establish the diagnosis of ectopic pregnancy are not always suYcient to predict rupture. Problem To determine the risk factors for rupture of an ectopic pregnancy to help physicians identify those women who are at greatest risk.

Clinicosociodemographic profile of ruptured ectopic pregnancies at a tertiary care centre

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017

Background: Rupture of an ectopic pregnancy remains the most dreaded complication of a pregnancy related event and is the commonest cause of maternal mortality in the first trimester of pregnancy. In the developing countries, the maternal death rate among patients admitted with ectopic pregnancy was found to be as high as one in ten. In addition to high risk for mortality, rupture of an ectopic pregnancy could affect future fertility of a woman. The objectives of this study are to analyse the sociodemographic and clinical characteristics and find out the incidence rate and risk factors associated with ruptured ectopic pregnancies in a tertiary care institution.Methods: This is a retrospective study and was conducted over a period of one year from September 2015 to September 2016 in Department of Obstetrics and Gynecology at Institute of Medical Sciences, BHU, Varanasi, India. It is a tertiary care centre getting referrals not only from nearby cities and hospitals but also from major...

Ou Tcome of Ectopic Pregnancy : A Prospective Clinical Study in a Teaching Hospital

Journal of Evolution of medical and Dental Sciences, 2015

Ruptured ectopic pregnancy is a life-threatening gynaecological emergency. OBJECTIVE: To study the incidence, risk factors, clinical presentation and management of cases that presented in our hospital. MATERIAL AND METHODS: This prospective study was conducted at the Department of Obstetrics and Gynaecology, Siddhartha Medical College, Vijayawada, between October 2012 to September 2015. All women presenting with ectopic pregnancy in the above period were included in the study. RESULTS: There were a total of 69 cases of ectopic gestation with an incidence of 3.73 per 1000 pregnancies, highest incidence between age group 20-25 years, majority of cases were either second or third gravida. Commonest risk factor was pelvic inflammatory disease. Most of the ectopic gestation occurred in the ampullary part of the tube. All cases were ruptured ectopic and commonest surgery performed was total salpingectomy. CONCLUSION: Early presentation, prompt diagnosis and management will decrease morbidity and mortality associated with ectopic pregnancy.

A Clinical Study on Ectopic Pregnancy in Govt. General Hospital Kurnool

Background: Ectopic pregnancy remains one of the important cause of maternal morbidity and mortality, if not diagnosed in time it will result in rupture leading to emergency laparotomy or laparoscopy endangering the mother's life. Due to increased incidence of infertility, ART, STI, early diagnostic procedures like ultrasound, there is a rising trend of ectopic pregnancies. Aims and Objective: The aim is to study the incidence, clinical presentation risk factors, site of ectopic, management modalities at Govt. General Hospital Kurnool, Andhra Pradesh. It is a retrospective observational study. 710 antenatal mothers were admitted to the labour room with first trimester complaints and those with diagnosed ectopic pregnancy from outside were included in the study. After admission necessary investigations were done, planned for surgery/conservative management depending on the patient profile. Most cases were taken up for emergency laparotomy. Age, parity, risk factors, treatment, intraoperative findings were collected and the data has been analysed. Of 710 patients admitted, 27(3.8%) cases of ectopic pregnancies in which 18(66.6%) presented as ectopic rupture of which 9 (50%) presented as rupture in shock and 9 (33.33%) presented as early diagnosis, either with ultrasonographic or clinical findings. Results: Ectopic pregnancy constituted 1.12% of all gynaecological admissions, and its incidence was 1-2%. The commonest age group of the patients was 25-30 years. 18(66.6%) patients presented in emergency with rupture ectopic of which 9(50%) presented as rupture in shock. 9(33.33%) patients were admitted, on the basis of early diagnosis, with incidental ultrasonography finding, or due to any of the mentioned symptoms, and confirmed on ultrasound. The commonest (85%) clinical presentation was abdominal pain, and the commonest (34%) identified risk factor was a previous history of sexually transmitted diseases confirmed as pelvic inflammatory condition or others. No death due to ectopic pregnancy was found during the study period. Conclusion: Ruptured ectopic pregnancy is of profound threat to the well being of the women, and if undiagnosed early, is the major cause of maternal morbidity and mortality, and has remained a reproductive health challenge in developing countries.

Pattern of Ruptured Ectopic Pregnancy in a Secondary Level Healthcare Facility

Bangladesh Medical Journal

Tubal rupture following an ectopic pregnancy is usually associated with profound hemorrhage which can lead to an unstable hemodynamic state that can risk the life of the patient. To explore the pattern of ruptured ectopic pregnancy in a secondary level healthcare facility, this Cross-sectional study was conducted among 100 ruptured ectopic pregnancy cases at 250 Bedded General Hospital, Tangail from January to November 2017. Cases were diagnosed by taking history (short period of amenorrhoea, acute lower abdominal pain and per-vaginal bleeding), clinical examination and relevant investigations (per-abdominal ultrasonography, TVS, CBC, serum ß-hCG level). Postoperatively, all the patients were followed up meticulously till discharge. The mean age of patients was 33.5(±7.8) years and the highest incidence (43%) was recorded in the age group of 26-30 years. All the patients were managed surgically with no record of case fatality. The most common site for the extra-uterine pregnancy was...

Ectopic pregnancy: a five year retrospective study in a tertiary care hospital

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2015

Background: A ruptured ectopic pregnancy is a true emergency and remains the leading cause of pregnancy related first trimester deaths. The objective was to study the clinical profile of ectopic pregnancy in a tertiary care hospital. Methods: It was a retrospective study conducted at Christian Medical College & Hospital, Ludhiana from 1st June 2009 to 31st May 2014. A total of 108 patients with ectopic pregnancy were analysed on clinical presentation, clinical findings, investigations, operative findings and outcome. Results: A majority of women (44.44%) were in the age group of 26-30 years and 50% were multigravida. Risk factors were identifiable in 71.29% patients. Amenorrhea (91.6%) and pain abdomen (92.82%) were the most common presenting symptoms. Twenty (18.51%) women had laparoscopy, 72 (66.67%) underwent an exploratory laparotomy and sixteen (14.81%) women received medical management. There were no maternal deaths and postoperative morbidity in the form of febrile illness (11.11%), and wound sepsis (4.62%) was seen. Conclusions: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. Early diagnosis and referral in hemodynamically stable state along with use of minimal access surgery or medical management can change the scenario of ectopic pregnancy in the developing world.

Analysis of ectopic pregnancy at a tertiary care hospital: one year study

International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2013

Background: Ectopic gestation is the leading cause of maternal mortality and morbidity in first trimester and is a major cause of reduced child bearing potential. The aims of our study were to understand the clinical profile, risk factors, sites and management modalities of ectopic pregnancy at tertiary care hospital. Methods: This is a retrospective study carried out for one year at the department of Obstetrics and Gynaecology of our institute. Data of the women admitted for management of ectopic pregnancy during January to December, 2010 was collected and analysed. Results: The proportion of ectopic pregnancy was 0.7 % at our institute. Majority of women 45(83.2%) were between the age group of 21-30 years. Pelvic inflammatory disease (PID) contributed to ectopic pregnancy in 16(29.6%) women. The most common symptom was lower abdominal pain, in 50(92.6%) women. Marked pallor was present in 25(46.3%) women and 38(70.4%) women had cervical motion tenderness. Out of all women, 10(18.5%), 18(33.3%) and 26(48.1%) women were managed successfully with methotrexate, laparoscopy and laparotomy respectively. The success rate was 83.3%, 90% and 100% with methotrexate, laparoscopy and laparotomy respectively. Blood and blood products were given to 25(46.3%) women. Conclusion: Ectopic pregnancy is a growing problem of reproductive age group. Women should be encouraged regarding early reporting of missed periods and made aware of complications of ectopic pregnancy and necessity of seeking urgent medical help as early as possible so that early diagnosis and prompt conservative surgical or medical management of ectopic pregnancy can be done.

Study of ectopic pregnancy in reference to diagnostic and treatment modalities

Introduction: An ectopic pregnancy occurs when a fertilized ovum implants outside the normal uterine cavity. It is the most important cause of maternal mortality and morbidity in the first trimester. Our aim is to explore the role of various diagnostic aids and treatment modalities in suspected & unusual cases. Materials & methods: Department of Obstetrics & Gynaecology, Sri Aurobindo medical college & post graduate institution, Indore, MP from April 2014 to July 2015. All patients included in the study were diagnosed with ectopic pregnancy, in reproductive age group of 15-49 years. Total 50 patients participated in the study. A pre structured and pre tested questionnaire was used to know age, parity, risk factors & modes of presentation of ectopic pregnancy. Result: Urine pregnancy test was positive in 45 (90%) of the cases. Ultrasonography diagnosed complex adnexal mass in 94% of the patients. Periodic Serum β-hCG done in 10 (20%) cases, The commonest site of ectopic pregnancy was fallopian tube in 48(96%) cases. Salpingectomy was the most commonly performed radical surgery (74%cases).Medical management was successful in 66.6% cases. Laparoscopic management was successful in 84.61% cases. Conventional Laparotomy was successful in 100% cases.74% patients had undergone salpingectomy, among which 20%) cases were successfully managed by laparoscopy, whereas 8% cases were successfully managed by methotrexate. 82% cases required blood transfusion. Significant anaemia (Hemoglobin <8g%) in 30 (60%) patients and Blood transfusions in 41 (82%) cases Conclusion: early diagnosis using various methods and management & treatment plan governs the outcome in case of ectopic pregnancy

Clinical course of ectopic pregnancy in a tertiary center: Observational study

IP innovative publication pvt. ltd, 2019

Objective: Ectopic pregnancy is a life-threatening obstetric emergency. The objective of the study was to highlight the incidence, clinical profile and the management of ectopic pregnancy. The study was conducted in Obstetrics and Gynecology department of ESIC PGIMSR Delhi over one year. It was an observational study. Materials and Methods: Pregnant women presenting in gynaecology emergency with pain abdomen or bleeding per vaginum or history suggestive of ectopic pregnancy in first trimester were assessed for intrauterine or extrauterine pregnancy. Written informed consent was obtained from each patient prior to the treatment. All pregnant women with intrauterine pregnancies were excluded. 77 pregnant women were found to have extrauterine pregnancy. All Hemodynamically stable cases were managed conservatively. Hemodynamically compromised cases were managed surgically. Surgical procedure performed was salpingectomy. These cases were followed with weekly beta hCG till it normalized. Outcome: Incidence, Age, Parity and the treatment given. Results: Incidence of ectopic pregnancy in the institution was 2.01%. 46.7% cases were among age group 20-30 years. Multigravida 46.7% were having more ectopic pregnancy. 99% of extrauterine pregnancy were located in the Fallopian tubes. 38.9% presented between 4-6 weeks period of gestation 10.3% managed conservatively. 11.6% were chronic ectopic pregnancies were operated. Salpingectomy was the main surgical procedure. Conclusion: Thus, high index of clinical suspicion of ectopic pregnancy must be kept in mind. Early diagnosis and prompt treatment can help in reducing maternal mortality and morbidity.

Clinical Profile of Ectopic Pregnancy

International Journal of Medical and Biomedical Studies

Background: A ruptured ectopic pregnancy is a true emergency and remains the leading cause of pregnancy related first trimester deaths. Methods: Hospital based Retrospective study conducted on women who presented to our hospital with ectopic pregnancy were analysed from the available hospital documents (bedside records, history, operation theatre records and yearly audit report). Results: The mean age - 27 ± 3 years.The majority of patients (47.36%) were within the age group 25–29years. A significant proportion (53%) of these were multiparous, while only 26.31%were nuliparous. Majority of the patients had amenorrhea of ?7 weeks. The commonest site of ectopic gestation was the ampullary region while the tubo-ovarian site had the lowest occurrence. Conclusions: Ectopic pregnancy remains a gynecological emergency in developing countries and a major challenge to the reproductive performance of women worldwide, it should be considered a relevant public health issue in India Keywords: E...