Suspected Ectopic Pregnancies and the Outcome in a Tertiary Care Hospital in South India
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 4
Abstract
Background: Ectopic pregnancy is potentially lethal obstetric emergency, early diagnosis of unruptured ectopic pregnancy is of paramount importance..During the past decade, transvaginal ultrasonography has given an earlier and clearer picture of early pregnancies, by ruling out ectopic pregnancy if intra uterine pregnancy is identified or it may strongly suggest an ectopic pregnancy if an adnexal mass is seen or in the presence of pelvic fluid. However in 15% of cases the report may be indeterminate, that is empty uterus, ectopic pregnancy not ruled out. It is this cohort of women with suspected Ectopic pregnancy that forms the subject of this study. Aim of the study was to study the outcome of pregnancies with indeterminate early pregnancy pelvic ultrasounds, admitted with clinical suspicion of ectopic pregnancy. Methodology: This is a retrospective cohort study conducted for 1 year in Sree Avittom Thirunal hospital, Government Medical College, Trivandrum, a tertiary care center. Statistical tests used are mean, SD, Percentage, chi square and Odds Ratio to assess association of the selected parameters with the Ectopic pregnancy. Results: The study identified 109 women admitted with clinical suspicion of ectopic pregnancy and were followed up of which 99 patients met the inclusion criteria.Of the 99 patients 26 were ectopic pregnancies, 34 were spontaneous miscarriages, and 39 were viable intra utrine pregnncy. The overall mean age of the patients at presentation was 26.87yrs. The majority of patients were in 25 - 29 yrs age group, which was also true for ectopic pregnancy and spontaneous abortions, but not for the patients in Intra Uterine pregnancy group where the maximum number of patients were in the g group of 20 – 24 yrs.( X 2 =12.4,P =0.001). There was more number of referred cases in all the three categories.60% 0f the suspected ectopic pregnancy were referred. Among the cases that were eventually ectopic pregnancy 65.38 had been referred. The association of gravidity and outcome was found significant with Chi-square =20.58; P =0.008. The majority of patients in Intra Uterine group were primi gravidas. The overall incidence of prior miscarriage in our study population was around 21%.History of Infertility was also studied and in this there were 14 (14.14%) patients with infertility. In the ectopic pregnancy group,19,2% gave history of treatment for infertility while 80.8% did not have history of infertility treatment. 11.53% of patients with ectopic pregnancy had a history of previous ectopic. Conclusion: Early detection of ectopic pregnancy is of paramount importance. Early detection can be challenging and a number of early ectopic pregnancies are missed at the initial medical examination. Documentation of risk factor is an essential part of history-taking, and asymptomatic clinic patients with risk factors may benefit from routine early imaging. However, more than half of identified ectopic pregnancies are in women without known risk factors.
Authors and Affiliations
Dr Bindu P.
Keywords
Related Articles
- EP ID EP284395
- DOI -
- Views 77
- Downloads 0
A study on the effectiveness of Diet and Physical Activity in Diabetes Mellitus patients attending in a clinic in Thiruvananthapuram, Kerala
Background: Type 2 diabetes is a serious growing public health burden. In overweight and obese patients, lifestyle modifications, including nutrition therapy, regular physical activity and weight loss, are considered fun...
Three-Dimensional Magnetic Resonance Angiographic Evaluation of Circle of Willis and Its Anatomical Variations in General Population
Background: Circle of Willis is the most important collateral circulation system in brain. Primary goal of imaging is to find out its integrity and hypoplastic for explaining the predisposition / cause of stroke and prio...
Open reduction and internal fixation of talar fractures using various approaches and its outcome: A case series study
Introduction: Talus fractures are common in injuries of high-energy mechanisms and also with other musculoskeletal injuries and systemic trauma. Treating talus fracture in the multiple injured patient is a challenge. Var...
Wilson's Disease Presenting as Parkinsonism
Wilson's disease (WD) is autosomal recessive disease. It has varied presentation so that WD need to consider in any patient with movement disorder under the age of 50 years. The three movement disorders associated with W...
Clinico-Microbiological Study of Necrotizing Fasciitis
Introduction: Necrotizing fasciitis (NF) is a rapidly progressive inflammatory infection of the fascia and necrosis of subcutaneous tissues. It is a surgical emergency which requires high degree of suspicion for early di...