Recent trends in risk factors of ectopic pregnancy: a retrospective study at a tertiary care centre

Background: Ectopic pregnancy occurs when a fertilized ovum implants at a site outside the uterine cavity.Methods: A retrospective study was conducted in patients of ectopic pregnancy at a tertiary care centre. All ectopic pregnancies reported during this time period were selected and case sheets were analysed. The risk factors causing the ectopic pregnancies were obtained by clinical history and physical examination mentioned in case sheets. A menstrual practice questionnaire (WHO) was filled telephonically to assess menstrual hygiene practices in our patients of ectopic pregnancy.Results: Risk factors found in our study were age group 21-30 years, multiparity, previous tubal surgeries, low socioeconomic status, past history of PID and poor menstrual hygiene.Conclusions: PID stands out as the most modifiable risk factor. Awareness for the same among adolescents, sexually active females and newlywed couples may prove of paramount importance to reduce the incidence of ectopic pregnancy in long term

Unmasking the elusive: an early gestational age placenta accreta case series to illuminate the path towards avoiding missed diagnosis

Placenta accreta is a condition characterized by the abnormal invasion of the placenta into the uterine wall, leading to torrential hemorrhage. This case series, highlights the importance of accurate diagnosis and early detection of this life-threatening complication. The incidence of this iatrogenic complication is rising due to increased caesarean deliveries. While in advance stages of pregnancy the chances of missing accreta are less but in early pregnancy the diagnosis may be elusive. Timely detection by using imaging modalities like ultrasound both 2D and colour Doppler, provide valuable clues. Misdiagnosis may be fatal, especially in the first trimester. The present case series presents 3 cases where initial diagnosis of missed abortion followed by repeated curettage and gestational trophoblastic disease (GTD) was made respectively. The agony of suffering leads the patient to our tertiary care center where the diagnosis of accreta was made. Accurate diagnosis and early detection of placenta accreta are vital to optimize patient outcome. Detecting the nicheand an anteriorly situated low lying placenta with history of previous birth by caesarian section should raise suspicion, and vigilance on the part of treating obstetrician is must