ECTOPIC THE OVERRATED DANGER
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 27
Abstract
BACKGROUND Motherhood an eternal, universal and inherent dream which every woman has!! This dream may not always be pleasant and it can involve tragedies as well. One of this is ectopic pregnancy, a pregnancy which can be life-threatening in a flash if not managed well and on time. The present study involves a study on all the cases of ectopic pregnancy who were admitted to the Yashwantrao Chavan Memorial Hospital during November 2016 to April 2017. MATERIALS AND METHODS A total of 50 patients who were referred and diagnosed as ectopic pregnancy cases were analysed between the period from November 2016 to April 2017. The study design is case series- All these cases were analysed after applying the inclusion and exclusion criteria with respect to the: 1. History, 2. Clinical presentation, 3. Investigations, and 4. Treatment. RESULTS The incidence of the ectopic pregnancy in the present study was 1:257 deliveries. The majority of the cases were multigravidas. In most of the cases, there were no identifiable risk factors. However, they did present with pain in the abdomen, amenorrhea and spotting per vagina in more than 80% of the cases. Almost, 52% were in a state of shock at admission. Ultrasound, a urine pregnancy test and culdocentesis were the investigative modalities which were used. All the cases were managed by surgical management. On laparotomy, a majority of the cases were found to be ampullary pregnancies followed by isthmic pregnancies. The tube was ruptured in 92% of the cases and there was a haemoperitoneum. Almost all the patients required intraoperative and/ or postoperative blood transfusions. There was only one case with post-operative morbidity in included cases. CONCLUSION The early diagnosis of an ectopic pregnancy is one of the greatest challenges for Gynaecologists in a day-to-day clinical practice. It requires a high index of suspicion as said in a saying, “You have to be Ectopic Minded to Diagnose an Ectopic Pregnancy.” To diagnose and treat ectopic conservatively gives hope for future fertility, but in case of our study centre being the referral centre very few of about 4% patients could be offered conservative line of management. At conclusion of the study, we have not found any significant increase or decrease in the incidence of ectopic pregnancy compared to in the past.
Authors and Affiliations
Mangal Santosh Supe, Nilesh Mhaske, Hrishikesh Mandhane, Jayashree Bandar
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