Trends of ectopic pregnancies in Andaman and Nicobar Islands

Yadav, Amita; Prakash, Avinash; Sharma, Charu; Pegu, Bhabani; Saha, Mrinmoy Kumar

doi:10.18203/2320-1770.ijrcog20164499

Cited by 14 publications

(48 citation statements)

References 2 publications

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“…This is in contrast to the study of Shaikh BN et al and Shanti Suri Asuri where 38% and 40.5% patients were brought in a state of shock. 16,8 Classic triad of pain, bleeding and amenorrhea was seen in 15 (31.9%) patients in our study which is similar to the study of Priyadarshini B. et al 8 In the present study, previous medical abortions and previous lower segment caesarean section were present in 17% and 12.8% patients respectively, which is quite comparable to the studies done by Priyadarshini Et al, Shanti Suri Asuri, Yadav et al and Saha et al 8,16,18,19 We found that history of infertility treatment was there in 8.5% patients almost similar to the studies of Shanti Sri Asuri, March Banks and Arora et al 16,20 In contrast it was quite higher in the studies of Mitra et al (55.2%), Savitha Devi et al(48.07%), Priyadarshini B. et al (21%) and Rose et al (15.1%). 8,16,21,22 In our study history of PID was present in 6.4% patients.…”

Section: Discussionsupporting

confidence: 91%

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A clinical study of ectopic pregnancy in a tertiary care centre in Central India

Shrivastava¹,

Parashar²,

Modi³

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONEctopic pregnancy is defined as when the gestational sac implants itself outside the uterus, i.e. fallopian tubes, ovary, cervix and peritoneum. It is an obstetric emergency with high morbidity and mortality. It is the fifth most common cause of death according to the most recent triennial report and also the most common cause of maternal mortality in first trimester. 1 The rate is about 1-2% of that of live births in developed countries, though it is as high as 4% in pregnancies involving assisted reproductive technology.2 It has been observed all over the world that incidence of ectopic pregnancy has increased during the last few years. A number of causes have been attributed to it of which most are due to changing living trends of the society; increasing maternal age, tubal surgeries, pelvic inflammatory diseases, endometriosis, exposure to diethylstilbestrol (DES) in utero, taking hormonal pills containing estrogen, use of an intrauterine device (IUD), history of tuberculosis and assisted reproductive techniques. A meta-analysis has identified four strongly associated risk factors from the ABSTRACT Background: Ectopic pregnancy is an obstetric emergency with high morbidity and mortality. The incidence of ectopic pregnancy is on a rise globally. Risk factors and causes for ectopic pregnancy may vary with the setting and geographically. Methods: A retrospective analysis of all operated ectopic pregnancies over a 5-year period; between June 2011 to May 2016, was done. Surgically confirmed cases were included in this study and a detailed analysis of presenting symptoms, age, parity and high risk factors was carried out. Results: A total of 50 patients were operated for ectopic pregnancy at our hospital during the study period. Analysis was done for 47 of these due to incomplete data for 3 patients. Majority (62%) of patients belonged to the age group 20-29 years and were gravida 3 and above. Ninety two percent were ruptured ectopic. Sixty two percent ectopic pregnancies were on right side. The common presenting complaints were pain in abdomen (81%) and bleeding/spotting per vaginum (43%). The mean duration between onset of symptoms and reporting to hospital was one and a half day and the average time between admission to hospital and surgery was 9 hours. The ectopic pregnancies were managed surgically in all cases. No obvious risk factors were identified in 34% patients. Among the remaining, previous MTP (17%), previous ectopic (9%) and PID (7%) were identified risk factors. There was no mortality. Conclusions: Surgical treatment was done more often because of patients reporting late to the hospital. Screening of high risk cases, early diagnosis and early intervention reduces the morbidity and mortality in ectopic pregnancies.

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Section: Discussionsupporting

confidence: 91%

“…No risk factor could be identified in 34% of patients in our study as in many other studies. 8,[16][17][18][19] We found that majority of patients had tubal ectopic pregnancy as in other studies. 18,29 However the exact site could not be made out in 53.2% patients during laparotomy due to extensive tubular damage.…”

Section: Discussionsupporting

confidence: 61%

A clinical study of ectopic pregnancy in a tertiary care centre in Central India

Shrivastava¹,

Parashar²,

Modi³

2017

Int J Reprod Contracept Obstet Gynecol

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“…7,[9][10][11][12][13][14][15][16]18,19 This is probably because sexual activity and fertility of women is highest during this period. In the present study, 70% of the women were multiparous which was comparable with studies by Bhuria et al, Rakhi et al, Yadav et al and Prasanna et al 8,15,18,19 In the present study, the commonest site for ectopic pregnancy was tubal (92%). Among the tubal pregnancies, ampulla was the commonest site (78%).…”

Section: Discussionsupporting

confidence: 91%

“…The incidence of ectopic pregnancy in other Indian studies conducted during 1996 to 2015 ranged from 0.25% to 1.9%. [6][7][8][9][10][11][12][13][14][15] We compared the incidence of ectopic pregnancy in the institute from 2011 to 2013 and found an increase in incidence from 4.7 per 1000 deliveries to 6.3 per 1000 deliveries. Similar to our study, there was an increasing trend in the incidence of ectopic pregnancies in the studies conducted by Jophy et al (7.4 per 1000 live births to 15.2 per 1000 live births) and Porwal et al 6,7 Shobeiri et al conducted a study of 872 women with ectopic pregnancy in Iran during 2000 to 2010.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, availability of ultrasound and other diagnostic modalities and improvement in health facilities has helped to reduce the maternal morbidity and mortality. [6][7][8] Absence of identifiable risk factors, varied clinical presentation, and non-availability of ultrasound may cause delay in diagnosis. Delayed diagnosis or late referral resulting in ruptured ectopic pregnancy may increase the maternal morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

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A study of incidence, risk factors, clinical profile and management of 50 cases of ectopic pregnancy in a tertiary care teaching hospital

Ganitha

Anuradha

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Ectopic pregnancy is a challenging and life-threatening emergency, which can cause significant maternal morbidity and mortality. The present study aims at determining the incidence, risk factors, clinical features, diagnosis, management and outcome of ectopic pregnancies in a tertiary care teaching hospital.Methods: This was a prospective study of 50 cases of ectopic pregnancies admitted to the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital from August 2012 to September 2013. Relevant data of the 50 patients was tabulated and descriptive analysis was carried out.Results: The incidence of ectopic pregnancy was 6.3 per 1000 deliveries. Majority of the patients (82%) belonged to 20-30 yrs age group. 70% of the women were multiparous. The commonest site of ectopic pregnancy was fallopian tube (92 %). Past history of pelvic inflammatory disease (40%), abortions (20%), abdominopelvic surgery (14%) and IUCD usage (12%) were among the important risk factors identified. 20% of the patients had no identifiable risk factor. The classical triad of amenorrhea, bleeding per vaginum and abdominal pain was seen in 56 % of the study population. The most important signs which guided the diagnosis of ectopic pregnancy were cervical excitation pain (74%), abdominal tenderness (72%), adnexal mass or fullness (68%) and tenderness in the fornix (68%). Clinical presentation, urinary pregnancy test, culdocentesis and ultrasound were the diagnostic tools used for diagnosis of ectopic pregnancy. The incidence of ruptured ectopic pregnancy was 86%. Majority of the patients underwent salpingectomy (96%). There was no maternal mortality in our study.Conclusions: Early diagnosis, timely referral, improved access to health care, aggressive management and improvement of blood bank facilities can reduce the maternal morbidity and mortality associated with ectopic pregnancy.

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A study of tubal ectopic pregnancy based on the histopathology of fallopian tubes in the age group of 20-35 years

et al. 2020

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Purpose: Ectopic pregnancy is a life-threatening condition for the mother. Disruptions of the fallopian tube are considered to be important in its pathogenesis. The present study was conducted to observe the histopathology of this dreaded disease which could lead to the development of suitable remedies. Methods: Cases diagnosed with ectopic gestation in the fallopian tube who subsequently underwent salpingectomy were considered for the study. Histopathology of sections from the affected fallopian tubes was studied under the light microscope after staining with H and E. Results: Most cases presented with amenorrhoea, whereas others had dysmenorrhoea, menorrhagia, and menometrorrhagia. Histopathologic findings included the presence of salpingitis (acute and chronic), calcification, sclerosed vessel and. Conclusion: Past history of inflammatory diseases, especially PID plays an important role in the subsequent development of ectopic pregnancy. Its prevention and treatment can lead to a decrease in the incidence of ectopic pregnancy.

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Trends of ectopic pregnancies in Andaman and Nicobar Islands

Cited by 14 publications

References 2 publications

A clinical study of ectopic pregnancy in a tertiary care centre in Central India

A clinical study of ectopic pregnancy in a tertiary care centre in Central India

A study of incidence, risk factors, clinical profile and management of 50 cases of ectopic pregnancy in a tertiary care teaching hospital

A study of tubal ectopic pregnancy based on the histopathology of fallopian tubes in the age group of 20-35 years

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