The Use of Abdominal Paracentesis in the Diagnosis of Ectopic Pregnancy in a Resource – Limited Setting
Journal Title: Journal of Gynecological Research and Obstetrics - Year 2017, Vol 3, Issue 2
Abstract
Ectopic pregnancy remains an important cause of morbidity and mortality in the first trimester of pregnancy, and has become a major public health challenge among women in the reproductive age group in this environment. A review of 139 consecutive cases of tubal ectopic gestations managed over a five year period at the Ekiti State University Teaching Hospital, Ado – Ekiti, Nigeria was conducted. Ectopic pregnancies accounted for 1.8% of all deliveries. Most of the women were married (68.3%), between 26 – 30 years (28.8%) and of low parity [0 and 1] (61.9%), and all had abdominal pain. Induced abortion (72.7%) was the commonest factor and the levonorgestrel-containing pill was the commonest contraceptive (19/43) associated with ectopic pregnancy. 16.5% were severely anaemic at presentation, 1 in 6 women had prior uterine evacuation as a result of wrong diagnosis, 26.7% had massive haemoperitoneum (≥2000 millilitres) and salpingectomy (84.1%) was the commonest operative procedure. Paracentesis was positive in 84.6% of cases and negative in the only unruptured case. The correct diagnosis was missed in a third of the patients at presentation. The case fatality rate was 0.7%. While improved diagnostic methods will reduce late presentations and tubal rupture, thereby improving the chances of tubal salvage and future reproductive outcome, a diagnostic algorithm that will include abdominal paracentesis may help to increase the pickup rate of ectopic pregnancy and be an impetus for immediate intervention in resource-poor settings.
Authors and Affiliations
JO Awoleke, AA Akintayo
Keywords
Related Articles
- EP ID EP337240
- DOI 10.17352/jgro.000032
- Views 106
- Downloads 0
Menstrual Stem cells
Stem cells isolated from menstrual fluid have mesenchymal stem cell like properties and have multi-lineage differentiation capacity. Menstrual fluid has ease of access in collection and repeated sampling is possible in a...
Prediction of Ovarian Response by Antimullerian Hormone in Women with Polycystic Ovarian Syndrome: A Randomized Prospective Study
Objective: To assess the effect of high level of circulating antimullerian hormone on the outcome of gonadotrophin ovulation induction in women with polycystic ovarian syndrome. Patients and Methods: This was a prospecti...
Association of genetic polymorphisms in DNA repair genes in polycystic ovary syndrome
Introduction: Polycystic ovary syndrome (PCOS) involves expression of chronic anovulation and hyperandrogenism. Role of environmental and genetic factors in PCOS is strongly supported but the genes that are positively in...
Socio-Demographic Determinants of Antepartum Fetal Death
Background: Antepartum fetal death (AFD) contributes significantly to stillbirths (SB) in low- and middle-income countries (LMIC). Modifying locally-prevalent demographic risk factors could lessen the burden of SB in the...
A Case of Severe, Silent Fetomaternal Haemorrhage (FMH) Detected by Mixed-Field in the Mother’s ABO Typing
Introduction: Fetomaternal haemorrhage (FMH) refers to the passage of fetal erythrocytes to the maternal circulation. In most pregnancies, small amounts of fetal erythrocytes can cross over to the maternal circulation wi...