Risk Factors Associated with the Rupture of Tubal Ectopic Pregnancy

Latchaw, Gregory A.; Takács, Péter; Gaitan, Lucia; Geren, Sasha; Burzawa, Jennifer K.

doi:10.1159/000088032

Cited by 45 publications

(38 citation statements)

References 31 publications

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“…Ruptured ectopic pregnancy was present in 62.3% cases, 24.5% had unruptured ectopic and tubal abortion in 13.9% cases In Latchaw G et al study, tubal rupture was present in 59% cases and 41% had unruptured ectopic pregnancies. They concluded that the patients with a history of a previous ectopic pregnancy are significantly more likely to experience a tubal rupture 24 . Studies have shown that low hemoglobin and hematocrit values, together with higher gravidity at the time of admission, may indicate an increased risk of tubal rupture 25 .…”

Section: Resultsmentioning

confidence: 99%

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

Yeasmin

Uddin

Hasan

2014

Chatt Maa Shi Hosp Med Coll J

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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.

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Section: Resultsmentioning

confidence: 99%

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

Yeasmin

Uddin

Hasan

2014

Chatt Maa Shi Hosp Med Coll J

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“…This is in agreement with previous studies that reported the number of previous EP as a major risk factor for a new episode of EP. 18,[20][21][22][23][24] Logistic regression showed that seven variables were significantly associated with IUP when compared with EP and SAB combined (age, number of previous EP, parity, a complaint of vaginal bleeding on presentation, number of live births, SAB, and HCG level on presentation). The most significant risk factor found for IUP was parity.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Outcome in Women with Symptomatic First-Trimester Pregnancy: Focus on Intrauterine Rather Than Ectopic Gestation

Casanova

Sammel

Chittams

et al. 2009

Journal of Women's Health

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Objective: Symptoms of vaginal bleeding and abdominal pain are common in cases of ectopic pregnancy (EP), spontaneous abortions (SAB), and complications of an intrauterine pregnancy (IUP). It is important to determine if efforts should focus on differentiating EP from an IUP (IUP ϩ SAB) or a viable IUP from a nonviable gestation (EP ϩ SAB) in women at risk for EP. Methods: This is a retrospective cohort study of women who presented with bleeding or pain or both during the first trimester of pregnancy. The cohort was divided into subjects diagnosed with IUP vs. (EP ϩ SAB). The same cohort was then divided into subjects diagnosed with EP vs. (IUP ϩ SAB). Logistic regression models based on risk factors for both outcomes (EP vs. Conclusions: Information collected at initial presentation from women at risk for EP to be used for building prediction rules should focus on differentiating a viable from a nonviable pregnancy rather than attempting to distinguish an extrauterine from an intrauterine pregnancy. However, this distinction should not affect current clinical care. 195

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“…In Latchaw G et al study, the same were 59% and 41% respectively. 20 Laparoscopy and medical therapy have now emerged as the widely used therapeutic modalities with great success in terms of reduced morbidity, shorter hospital stay and conservation of fertility. 21 However choice depends upon early identification of ectopic pregnancy and hemodynamic status of the patients.…”

Section: Discussionmentioning

confidence: 99%

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

Poornima

Lalitha

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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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.

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Risk Factors Associated with the Rupture of Tubal Ectopic Pregnancy

Cited by 45 publications

References 31 publications

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

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

Prediction of Outcome in Women with Symptomatic First-Trimester Pregnancy: Focus on Intrauterine Rather Than Ectopic Gestation

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

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