Ectopic pregnancy at Aminu Kano Teaching Hospital, Kano, Nigeria

Background: Ectopic pregnancy is an important cause of maternal morbidity and mortality in developing countries like Nigeria. The incidence of ectopic pregnancy is on the increase worldwide.Objective: To determine the influence of age and parity on the incidence of ectopic pregnancy, findings at operation and pattern of treatment of ectopic pregnancy at Aminu Kano Teaching Hospital (AKTH), Kano,Nigeria.Methods: It was a descriptive retrospective study of 178 patients that were admitted with ectopic pregnancy at Aminu Kano Teaching Hospital between January 2006 and December 2009.Results: The incidence of ectopic pregnancy was 11.7 per 1000 deliveries, 14.7% of all gynaecological operations and 74.8% of all gynaecological emergency operations. Modal age and parity were 25-29 years age group, and para 1. Ruptured ectopic pregnancy ( 75%), right tubal ectopic pregnancy (58%) and ampullary implantation (66.9%) were the most common presentations. Hemoperitoneum of greater than 1 litre occurred in 62.7% of the cases, but only 11.8% had autotransfusion of blood. There was a rising trend in the incidence of ectopic pregnancy during the study period.Conclusion: Ectopic pregnancy is the commonest gynaecological emergency at AKTH. Early girl marriage made ectopic pregnancy to be more associated with older parous women. Ruptured ectopic pregnancy was the commonest presentation, which calls for community campaign to encourage early presentation in the hospital. Autotransfusion where not contraindicated should be used more in the management of ruptured ectopic pregnancy.  Key words: Ectopic pregnancy, incidence, operative findings, pattern of treatmen

The use of measurements of hCG and other pregnancy-associated proteins and steroids in the diagnosis of ectopic pregnancy

The measurement of serum of urinary hCG is commonly used to make or exclude the diagnosis of ectopic pregnancy in women presenting with symptoms suspicious of ectopic pregnancy. Detection of depressed hCG levels is indicative of early pregnancy failure. Depressed serum levels of proteins of hormone of trophoblastic, ovarian or endometrial origin make the diagnosis of ectopic gestation more likely, whilst high values are likely to exclude the possibility of this condition.peer-reviewe

Cesarean Scar Ectopic Pregnancy: Diagnosis With Ultrasound

We present a rare case of cesarean scar ectopic pregnancy as diagnosed by transvaginal ultrasonography. Cases such as this are rare, but they are becoming more commonly detected with the growing frequency of cesarean sections, improving technology, and provider proficiency with point-of-care ultrasound. Quick identification of this dangerous diagnosis can be life saving for the patient, as the outcomes of ruptured cesarean ectopic pregnancy may include significant hemorrhage, uterine rupture, and possibly maternal death

Intramural pregnancy: a diagnostic dilemma for an obstetrician

Intramural ectopic pregnancy is one of the rarest types of ectopic pregnancy,with risk of 1:30000.Confirmation of intramural ectopic pregnancy is difficult and is often performed intraoperatively.Intramural ectopic pregnancy often requires hysterectomy to avoid life-threatening haemorrhage.We present a case of intramural ectopic pregnancy in the second trimester.Transvaginal ultrasound and MRI are important non-invasive methods in diagnosing this type of ectopic pregnancy.Clinicians should provide consideration to a combination of strategies and do their best to preserve patient’s ”uteri and fertility”

Recurrent ipsilateral ectopic pregnancy after partial salpingectomy: case-report

Ectopic pregnancy is a life-threatening condition occurring in 1-2% of all pregnancies. The most common site of implantation for an ectopic pregnancy is the fallopian tube. Authors report a case of recurrent ipsilateral ectopic pregnancy following right partial salpingectomy of a 29-Year-Old woman that led to tubal rupture. The pregnancy was conceived spontaneously. Diagnostic of ruptured ectopic pregnancy was done after clinical and ultrasonography examination. The presence of a massive hemoperitoneum with a positive pregnancy urinary test that lead us to the diagnosis of ectopic pregnancy. She underwent a laparotomy for a suspicion of ruptured ectopic pregnancy. The ectopic pregnancy was identified in the left remnant fallopian tube. Partial salpingectomy, removal of tubal stump, and resection of the uterine cornua, was performed. The postoperative recovery was uneventful. She has stayed for five days at the Hospital. All patients, even though they have already received a definitive contraception by tubal section and ligature or unilateral or by bilateral salpingectomy for any reason, must seek an ectopic pregnancy in case of pelvic pain, vaginal bleeding and/ or amenorrhea. Authors propose to carry a total salpingectomy after a chosen surgical treatment

Relationship of IL-6 and IL-8 levels with tubal ectopic pregnancy

Background: The frequency of ectopic pregnancy (EP) has increased worldwide during the last 30 years, particularly in underdeveloped countries with low early diagnostic rates. Ectopic pregnancy is the major cause of first-trimester deaths. Interleukins are immunomodulatory cytokines that modulate inflammatory responses and help humans conceive. Aim of the study was to evaluate the predictive value of interleukin-6 and interleukin-8 in tubal ectopic pregnancy. Methods: This case control research was undertaken in the Department of Obstetrics and Gynaecology at Al-Emamein Al-Kadhemein Medical City/Baghdad from January 1, 2022 to January 1, 2023. The study analysed 30 patients with missed cycles, positive β-HCG tests, vaginal bleeding, and ruptured tubal ectopic pregnancy diagnosed via transvaginal ultrasound (group A) and 30 patients with intrauterine missed miscarriage (group B). The control group (group C) included 30 ladies with uncomplicated intrauterine pregnancies of matched gestational age. Results: Interleukin-6 was substantially greater in ectopic pregnancy than miscarriage and normal intrauterine pregnancy. Ectopic pregnancy and miscarriage had higher levels of interleukin-8 than normal intrauterine pregnancy, but there was no difference. Interleukin-6 levels ≥76.1 pg/ml were linked to 90% sensitivity and 85% specificity in predicting ectopic pregnancy. Interleukin-8 was neither sensitive nor specific for ectopic pregnancy. Conclusions: Measurement of IL-6 may have a predictive value in cases of ruptured tubal ectopic pregnancy. IL-8 was a poor predictor for ectopic pregnancy

Risk factors for ectopic pregnancy: an institutional study in a tertiary care hospital

Background: Ectopic pregnancy is the leading cause of maternal death during the 1st trimester of pregnancy, accounting for approximately 10% of all pregnancy related deaths. A better understanding of ectopic pregnancy risk can help prevent its occurrence. The present study was designed to evaluate the ectopic pregnancy risk factors and their strength of association with ectopic pregnancy at a tertiary care hospital.Methods: It was a prospective study with 104 cases of ectopic pregnancy and 125 controls conducted in the Department of Obstetrics and Gynecology, SCB Medical College, Cuttack for a period of 1 year. Detailed history suggestive of risks factor for ectopic pregnancy, menstrual and obstetrics history was taken. General, systemic, abdominal and vaginal examination was done. Diagnosis of ectopic pregnancy was confirmed by clinical examination, urine pregnancy test, ultrasonography and culdocentesis and only confirmed cases were included in the study group. Healthy pregnant women were taken as control group.Results: The study revealed that the risk of ectopic pregnancy was associated with the traditional risk factors including previous EP [Adjusted odds ratio (AOR) = 9.98, 95% CI: 0.89-11.1%], previous infertility (AOR= 7.29, 95% CI:2.53-21.0) and previous history of sterilization (AOR=12.47,95% CI: 3.50 - 44.4) and previous history of abortion (AOR= 3.10, 95% CI: 1.53-6.30). Age comparison between cases and controls revealed that the ODDS of having ectopic pregnancy was 4 times in the age group 30 to 35 years as compared to uterine pregnancy and this difference was statistically significant (P value = 0.007).Conclusions: Risk factors such as previous ectopic pregnancy, induction of ovulation, intra uterine device usage, abortion as well as increased maternal age along with recent diagnostic tools aid in early detection of ectopic pregnancy in women resulting in proper and timely treatment

Incidence and risk factors associated with ectopic pregnancy: a prospective study

Background: Increased incidence of ectopic pregnancy and its impact on women’s fertility in recent years need significant attention.Methods: A two years prospective study from January 2018 to December 2019 conducted to determine incidence, association of risk factors with ectopic pregnancy and find the most common risk factor of ectopic pregnancy in department of obstetrics and Gynaecology, a tertiary care Hospital in Pune.Results: During the study period 100 patients were diagnosed to have ectopic pregnancy. Incidence was 5.29 per 1000 births. Majority were in the age group of 20-24 years (42%), multiparous (59%) and belong to low socioeconomic state (62%). In majority of the patients (22%) no risk factors was found. Among the patients who had risk factors, the main risk factors for ectopic pregnancy were history of history of pelvic inflammatory disease (20%), previous tubal/abdominal surgery (12%), history of Infertility (10%), previous termination of pregnancy (10%), contraception with mirena IUS or IUCD in situ (8%) and a history of prior ectopic pregnancy (4%).Conclusions: In majority (78%) of patients risk factors for ectopic pregnancy was present and pelvic inflammatory disease was found to be a major risk factor for ectopic pregnancy

Cervical Ectopic Pregnancy in Resource Deprived Areas: A Rare and Difficult Diagnosis

Ectopic pregnancy is a common cause of morbidity and mortality in women of reproductive age especially in resource deprived areas worldwide. Cervical ectopic pregnancy is a rare, life threatening form of ectopic pregnancy which needs a high index of suspicion for diagnosis, thus adding a complex twist to the dilemma faced by the obstetrician in resource deprived areas. A case of a cervical ectopic pregnancy which presented in a resource deprived area in a region in Ghana is discussed, and the difficulties encountered in diagnosis and management of this lifethreatening condition are outlined.Keywords: Ectopic pregnancy, cervical, resource deprived areas, difficult diagnosis, managemen