Reporting rates of ectopic pregnancy: Are we any closer to achieving consensus?

Rosnay, Philippe de; Irvine, L. M.

doi:10.3109/01443615.2011.618894

Cited by 4 publications

(5 citation statements)

References 14 publications

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“…Institutional tubal EP rates were calculated per 1,000 births (live births and stillbirths ≥ 24 weeks’ gestation) [12]. Delays were categorised according to the ‘three phases of delay’ model [32].…”

Section: Methodsmentioning

confidence: 99%

“…Equally, the use of different denominators for reporting EP rates hinders comparison internationally (e.g. number of EP per 1,000 deliveries, or per 10,000 women at reproductive age) [12]. Nevertheless, available data suggests EP is a relatively common gynaecological emergency in LMICs, its case fatality is high [7] and its incidence is rising [6,7,13].…”

Section: Introductionmentioning

confidence: 99%

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The impact of tubal ectopic pregnancy in Papua New Guinea – a retrospective case review

Hamura¹,

Bolnga²,

Wangnapi

et al. 2013

BMC Pregnancy Childbirth

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BackgroundEctopic pregnancy (EP) is an important cause of morbidity and mortality amongst women of reproductive age. Tubal EP is well described in industrialised countries, but less is known about its impact in low-resource countries, in particular in the South Pacific Region.MethodsWe undertook a retrospective review of women with tubal EP treated at a provincial referral hospital in coastal Papua New Guinea over a period of 56 months. Demographic and clinical variables were obtained from patients’ medical records and analysed. The institutional rate of tubal EP was calculated, and diagnosis and management reviewed. Potential risk factors for tubal EP were identified, and delays contributing to increased morbidity described.ResultsA total of 73 women had tubal EP. The institutional rate of tubal EP over the study period was 6.3 per 1,000 deliveries. There were no maternal deaths due to EP. The mean age of women was 31.5+/−5.7 years, 85% were parous, 67% were rural dwellers and 62% had a history of sub-fertility. The most commonly used diagnostic aid was culdocentesis. One third of women had clinical evidence of shock on arrival. All women with tubal EP were managed by open salpingectomy. Tubal rupture was confirmed for 48% of patients and was more common amongst rural dwellers. Forty-three percent of women had macroscopic evidence of pelvic infection. Two-thirds of patients received blood transfusions, and post-operative recovery lasted six days on average. Late presentation, lack of clinical suspicion, and delays with receiving appropriate treatments were observed.ConclusionsTubal EP is a common gynaecological emergency in a referral hospital in coastal PNG, and causes significant morbidity, in particular amongst women residing in rural areas. Sexually transmitted infections are likely to represent the most important risk factor for tubal EP in PNG. Interventions to reduce the morbidity due to tubal EP include the prevention, detection and treatment of sexually transmitted infections, identification and reduction of barriers to prompt presentation, increasing health workers’ awareness of ectopic pregnancy, providing pregnancy test kits to rural health centres, and strengthening hospital blood transfusion services, including facilities for autotransfusion.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of tubal ectopic pregnancy in Papua New Guinea – a retrospective case review

Hamura¹,

Bolnga²,

Wangnapi

et al. 2013

BMC Pregnancy Childbirth

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“…Hence, it is likely that we are underestimating ectopic pregnancy as a cause of early maternal death and hence there is a need to estimate the overall contribution of ectopic pregnancy to maternal death. 7 The diagnosis of ectopic pregnancy in our study was predominantly based on a combination of history, clinical signs and ultrasound examination. Presence of complex adnexal mass was the most common ultrasound feature seen in more than 50% of the cases.…”

Section: Discussionmentioning

confidence: 99%

A clinical study of ectopic pregnancy: a five-year institutional experience

Malavika

Prabhudev

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONEctopic pregnancy is implantation of the fertilized ovum outside the uterine cavity. Depending on the location it can be tubal, ovarian, cervical, abdominal and can even occur on the caesarean scar.1 Although the total number of pregnancies are decreasing with time there is an increase in the incidence of ectopic gestation over the past few decades, owing to rise in sexually transmitted infections, increasing subfertility and its treatment with ART techniques, and many other risk factors. Tubal ectopics comprise the majority accounting for almost 95 to 97% of total ectopics. Tubal ectopics are usually associated with predisposing risk factors which are known to damage the tubal epithelium. 1,2Most common risk factor is sexually transmitted infections and PID resulting in salpingitis and partial occlusion of fallopian tube. With the advent of antibiotic treatment for PID and STI's, agglutination of cilia can occur and result in band formation and partial tubal occlusion. Sexually transmitted infections (particularly ABSTRACT Background: Ectopic pregnancy contributes significantly to maternal morbidity and mortality. There is a steady increase in the incidence of ectopic pregnancy over the past few decades, owing to rise in sexually transmitted infections, subfertility and its treatment with ART techniques. Objective of present work was to study the rate of ectopic pregnancy, associated risk factors, clinical course and management at SSIMS and RC. Methods: This is a retrospective study carried out at SSIMS and RC, Davangere from 01 st January 2012 to 30 th April 2017. A detailed analysis of case sheets done and all parameters analyzed. Institutional ectopic rate was calculated per 1000 deliveries. Results: Out of 43 women with ectopic gestation, 40 (93.02%) were tubal ectopic and 3 (6.98%) were ovarian ectopic. Institutional rate of ectopic is 11.54 per 1000 deliveries. STI's are the commonest risk factor followed by subfertility. Diagnostic aid commonly used was pelvic ultrasound. There were no maternal deaths due to ectopic pregnancy. One third of the women presented with shock. 52.5% tubal and 66.6% ovarian ectopics were ruptured. All women with tubal ectopic were managed by salpingectomy either by open or laparoscopic method and ovarian ectopics managed by ipsilateral oophorectomy. Two-thirds of the women received blood transfusion and 5-7 days were required for post-operative recovery. Conclusions: Ectopic pregnancy is one of the commonest gynecological emergency and there is a yearly increase in the rate of ectopic. STI's and subfertility are important risk factors. Prevention, early detection and treatment of STI's may play an important role in reducing the rate of ectopic pregnancy.

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“…The case fatalities from ectopic pregnancy in many developed countries have been on the decline due mainly to improved diagnostic techniques especially the use of transvaginal ultrasonography and prompt interventions employing medical and or new surgical management approaches 8,27 . These newer interventions are not readily available in low resource settings like ours where the exact burden of ectopic pregnancy is unclear due to shortcomings in documentation and reporting, delays in seeking or reaching healthcare facilities, difficulty in making diagnosis or outright misdiagnosis, and the use of different denominators for reporting ectopic pregnancy rates 8,[28][29][30][31] . Open laparotomy and salpingectomy still remained the commonest treatment modality for tubal ectopic pregnancy in our region 8,15,29 . This study was meant to develop the first basic and original data on ectopic pregnancy in our centre, being the first retrospective study on this subject matter since the institution became a teaching hospital.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and presentation of ectopic pregnancy in a tertiary hospital in Enugu south-east Nigeria: A 10-year retrospective study

Calistus Obiora NEVO,

Ifeanyi Johnson ONYEKPA,

Boniface Uwaezuoke ODUGU

2023

World J. Adv. Res. Rev.

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Background: Ectopic pregnancy is a leading cause of maternal mortality in the first trimester. The prevalence rate varies with time and with the population under study. While the mortality rate appears to be on the decline, most cases in this part of the world still present in ruptured state necessitating invasive management through open laparotomy. Aim: The aim of this research is to assess the prevalence and the pattern of presentation of ectopic pregnancy at the Enugu State University Teaching Hospital (ESUTH) Parklane, Enugu Nigeria. Methodology: This is a 10-year retrospective study from 31st December 2022 to 1st January 2013. Data was collected from ward admission and discharge records, case notes and theatre operation registers of all ectopic pregnancy-related cases during the study period. Information related to patients’ age, pattern of presentation, nature of treatment given, and the outcome of such treatment were obtained in a prepared proforma. Data was analyzed using IBM SPSS version 24 and the results presented in frequency tables and charts. Results: A total of 16,100 deliveries and 4,704 gynaecological admissions were recorded during the study period. There were 172 ectopic pregnancies giving a prevalence of 1.1% of total deliveries and 3.7% of all gynaecological admissions. The peak age incidence was 26-30-years and 86% of the patients presented in ruptured state while open laparotomy with salpingectomy was the only mode of treatment for tubal ectopic pregnancies. No mortality was recorded during the study period. Conclusion: The Prevalence of ectopic pregnancy is still relatively high in our environment and ruptured ectopic pregnancy remains a major cause of maternal morbidity and mortality. Even though our study did not record any maternal death in the past 10 years, serious maternal morbidities still persist. Strategies to sensitize women and ensure timely diagnosis and management of ectopic pregnancy will reduce these related morbidities.

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Reporting rates of ectopic pregnancy: Are we any closer to achieving consensus?

Cited by 4 publications

References 14 publications

The impact of tubal ectopic pregnancy in Papua New Guinea – a retrospective case review

The impact of tubal ectopic pregnancy in Papua New Guinea – a retrospective case review

A clinical study of ectopic pregnancy: a five-year institutional experience

Prevalence and presentation of ectopic pregnancy in a tertiary hospital in Enugu south-east Nigeria: A 10-year retrospective study

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