Late ectopic pregnancy

Cunningham, J. F.

doi:10.1007/bf02949118

Cited by 10 publications

(17 citation statements)

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“…Instead of implanting in the uterine wall, the embryo implants in the fallopian tube [23]. Studies have shown that the association of ectopic pregnancy with previous pelvic surgery may be due to peritoneal and peritubal adhesions that occur following these surgeries [22,24].…”

Section: Discussionmentioning

confidence: 99%

A 10 Year Review of 255 cases of Ectopic Pregnancy

2013

J Androl Gynaecol

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Objective: The study was conducted to determine the frequency, risk factors, clinical features and diagnostic modalities of Ectopic Pregnancy in a tertiary care hospital.Study design: Retrospective, Analytic study.Place and duration of study: Gynae B ward, Ayub Teaching hospital, Abbottabad, from Jan 2003 to Dec 2012. Methodology:The patients included in this study were admitted from outpatient department and emergency department to gynaecological unit. A detailed history was taken and examination was done. Variables like age of the patient, parity, past history, symptoms, signs, and operative procedure were all recorded for evaluation. Various predisposing factors like previous abortion, contraception, recurrent ectopic, previous pelvic surgery, infertility treatment and pelvic inflammatory disease were analyzed.Results: There were 255 cases of Ectopic pregnancy out of 25010 deliveries during the study period and the frequency was 1.01%. The main predisposing factor to ectopic pregnancy was pelvic inflammatory disease (43.13%) while 37.64% had previous abortions. Recurrent ectopic pregnancy was observed in 9.01% of patients while 27.05% had history of previous pelvic surgeries. Conclusion:The most common risk factor for ectopic pregnancy is pelvic inflammatory disease. If it is timely diagnosed and properly treated, ectopic pregnancy with its grave consequences can be avoided. MethodologyThe study was conducted in Ayub Teaching Hospital, Abbottabad in the department of Gynae & obstetrics from January 2003 to December 2012. The patients included in this study were from outpatient department and emergency department. Patients who had any four of the following features are included in the study, i.e history of amenorrhea not more than 12 weeks, positive pregnancy test, abdominal pain ,empty uterus on scan, adenexal mass, positive culdocentesis.A detailed history regarding age of the patient, parity, symptoms like amenorrhoea, per vaginal bleeding, abdominal pains, dizziness and vomiting was taken. Past history of repeated abortions, surgical interventions, infertility, pelvic inflammatory disease, history of contraception and ovulation induction was also taken. Pelvic inflammatory disease was diagnosed on the basis of history of repeated foul smelling vaginal discharge, fever and repeated antibiotic cover. Patients were particulary asked about previous record of ultrasound to see whether they had intrauterine or extrauterine pregnancy.Patients were examined and signs like shock, features of peritonism, abdominal tenderness, cervical excitation and adnexal tenderness were noted. Paracentesis and culdocentesis were also performed in some cases. Provisional diagnosis of ectopic pregnancy was made either by history and clinical examination alone or was supplemented by investigations like trans abdominal scan, trans vaginal scan, urinary beta HCG and serum beta HCG. Diagnostic laparoscopy was not considered in any case. Patients who came in shock were examined in detail and based on history and examination, dia...

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Section: Discussionmentioning

confidence: 99%

A 10 Year Review of 255 cases of Ectopic Pregnancy

2013

J Androl Gynaecol

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“…Tubal ectopic pregnancy is an important cause of maternal morbidity and mortality especially in developing countries where the majority of the patients tend to present lately with rupture ectopic and hemodynamic compromise. The risk of death from extra-uterine pregnancy is 10 times more than that of vaginal delivery, and 50 times greater than induced abortion [4]. Ectopic pregnancy is defined as a pregnancy where the implantation of the blastocyst occurs outside the uterine cavity, most frequently within the fallopian tube (ampullary, ischemic, and interstitial portions of the tube).…”

Section: Introductionmentioning

confidence: 99%

Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital

Aj¹,

Dikrayat²

2017

Crit Care Obst & Gyne

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Objective: To determine the frequency of tubal ectopic pregnancy and to evaluate the epidemiological and common predisposing factors in cases study. To determine the mode of management of tubal ectopic pregnancy.Study Design: This is a prospective descriptive analytic study carried out from 1 January 2013 until 31 December 2013 at obstetric and gynecological unit at Al-Thawra Hospital in Sana'a, Yemen.Results: Total number of deliveries from the 1st of January 2013 till the 31st of December 2013, were a total of 9330 deliveries, out of which 103 women had tubal ectopic pregnancy creating an incidence of 1.1% of the total deliveries with a ratio of 11/1000 live births. The mean age of the patients was 27.8 yrs and ranged between 17-40 years of age. It was most common in multipara with a percentage of 78.67 54.4% of women were Qat chewers and smokers. It was more commonly found in women of low economic status with 90.3%. 30.1% of women with it had a history of abortion, 70.9% had a history of pelvic inflammatory disease, 20.8% had a history of an abdominopelvic surgery, 11.7% were using intrauterine device and 5.8% were using progesterone-only pills, 1.9% had a history of tubal sterilization, 88.3% presented with abdominal pain, 72.8% gave a history of amenorrhea, 63.1% presented with vaginal bleeding, 79.6% presented with hemodynamic instability, 86.5% were treated surgically, and 14.5% were treated medically using Methotrexate. The surgical treatment was salpingectomy in 90.4%, and 6.6% was salpingostomy. There were no maternal mortalities. Conclusion:The most common risk factors found in patients with tubal ectopic pregnancy were previous abortions and PID. The majority of the patients were treated surgically as they were lately presented in a state of hemodynamic instability. 14.5% were treated medically and this proved to be very effective.

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“…Ektopik gebelik tüm gebeliklerin %2'sinde görülür ve gebeliğe bağlı anne ölümlerinin %10'nundan sorumludur (2). Ektopik gebeliğin klasik semptomları, adet gecikmesi, vajinal kanama ve abdominal ağ-rıdır.…”

Section: Introductionunclassified

“…Günümüzde, seri hormonal değerlendirme ve transvaginal ultrasonografinin kullanımı tanıyı kolaylaştırmış, rüptür meydana gelmeden önce ektopik gebelik olgularının tedavisini sağlamıştır. Erken tanı ve tedavi ektopik gebeliğe bağlı mortalitede dramatik bir azalma sağlamıştır (2). Ektopik gebelik için üç farklı tedavi yöntemi mevcuttur; ekspektan yaklaşım, medikal tedavi ve cerrahi tedavi.…”

Section: Introductionunclassified

The Evaluation of Patient with Diagnosis of Ectopic Pregnancy in Our Clinic

Gençdal¹,

Bozkurt²,

Paşaoğlu³

et al. 2015

JAREM

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ÖZETAmaç: Ektopik gebelik nedeniyle kliniğimize yatırılan hastaların demografik bulgularının, risk faktörleri, tanı bulguları ve tedavi yöntemlerinin retrospektif olarak değerlendirilmesi. Methods: A total of 42 women who were diagnosed as having an ectopic pregnancy at Kafkas University Medicine Faculty Health Research and Practice Center between March 2013 and May 2014 were enrolled in this study. During investigation of the records, age, obstetric history, last menstrual period, complaint, physical signs, risk factors, contraception method, β-HCG levels, fetal cardiac activity, and diameter of the ectopic mass in the transvaginal ultrasonography and treatment methods were evaluated.Results: The mean age of the patients was 30.6 (20±44) years; 11 patients applied with pain (26%), 5 (12%) applied with delay of menstrual bleeding, and 8 (19%) applied with vaginal bleeding. Mean β-HCG level was 3541 mIU/mL (200-29611). Mean gestational age was 6 (6±1.8). With the transvaginal ultrasonography, ectopic foci were detected in 27 (64.2%) patients. The mean diameter of ectopic foci was 37 mm (15-54). In 4 (9.6%) patients, fetal cardiac activity was obtained. As we looked to treatment procedures, 33 (78.5%) patients had surgery, 4 (9.5%) were treated medically, and 5 (12%) patients were managed expectantly. Among 33 patients who had surgery, 26 (78.8%) patients had laparoscopic surgery, and 7 (21.2%) had a laparotomy. All patients were discharged with complete recovery. No complications were observed.Conclusion: Ectopic pregnancy is still an important issue because of the high mortality, morbidity, and influenced on fertility. The treatment of ectopic pregnancy should be individualized, and all treatment procedures and future reproductive performance must be argued with patients. (JAREM 2014; 4: 93-6)

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Late ectopic pregnancy

Cited by 10 publications

References 1 publication

A 10 Year Review of 255 cases of Ectopic Pregnancy

A 10 Year Review of 255 cases of Ectopic Pregnancy

Frequency of Tubal Ectopic Pregnancy and Mode of Management at Al-Thawra General Modern Hospital

The Evaluation of Patient with Diagnosis of Ectopic Pregnancy in Our Clinic

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