THE CONFUSING PRESENTATIONS AND FACES OF ECTOPIC PREGNANCY IN CONCORDANCE WITH DIAGNOSTIC MODALITIES IN A TERTIARY CARE HOSPITAL IN NORTH EASTERN SECTOR OF INDIA - A STUDY OF 2 YEARS PERIOD

Year 2019, Volume: 2 Issue: 2, 20 - 24, 31.12.2019

Dr Ragini Thapa Sinam Tombi Meetei Talitha Talitha

Abstract

Background: The study was taken up to know the about the
various diagnostic criteria used for ectopic pregnancy.

Methods: This  study
included seventy patients diagnosed as ectopic pregnancy. Clinical signs, symptoms
and physical findings were recorded. Urine pregnancy test, serum β hCG and
abdominal ultrasound were the main diagnostic modalities. Findings at
laparoscopy and laparotomy were analysed.

Results: Majority of the women presented with abdominal
pain (90%) and amenorrhea (97.14%).Majority(82.84%) had amenorrhea ranging from
4 weeks or less to 8 weeks.  Cervical excitation
was positive in 64.28% and adenexal mass was palpable in 15.7%. Urine pregnancy
test and serum β  hCG  were positive in 82.8% and 95.2%. ,
respectively. Findings suggestive of ectopic were found in 81.42% on
transabdominal ultrasound exam. Twenty-five patients (35.6%) underwent
diagnostic laparoscopy while 98.5% underwent laparotomy.

Conclusion: Availability of sensitive and specific radio-immunoassays
of β-human chorionic gonadotrophin (β-hCG) and high resolution transvaginal
ultrasound (TVS) allows early detection of ectopic pregnancies 

Key Words: Ectopic pregnancy , Serum  β- hCG,Laporoscopy 

Keywords

Ectopic pregnancy, Serum β- hCG

References

• 1. Alkatout I , Honemeyer U ,Strauss A ,Tinelli A ,Malvasi A ,Jonat W,Mettler L ,Schollmeyer T. Clinical diagnosis and treatment of ectopic pregnancy .Obstet Gynecol Surv 2013 ;68 ( 8 ) :571 – 581 . 2. American College of Obstetricians and Gynecologists.Practice Bulletin94: Medical Management of Ectopic Pregnancy . Washington, DC: ACOG,2008 (reaffi rmed 2014) . 3. Gracia CR , Barnhart KT . Diagnosing ectopic pregnancy: decision analysis comparing six strategies .Obstet Gynecol 2001;97 (3) :464 – 470 . 4.Barnhart KT,Sammel MD ,Rinaudo PF ,ZhouL ,Hummel AC ,Guo W . Symptomatic patients with an early viable intrauterine pregnancy: HCGcurves redefi ned .Obstet Gynecol 2004 ; 104 (1) :50 -55 . 5.Daniilidis A , Pantelis A , Makris V, Balaouras D , Vrachnis N. A unique case of ruptured ectopic pregnancy in a patient with negative pregnancy test—a case report and brief review of the literature Hippokratia 2014 ; 18 ( 3 ) :282– 284 6. Adhikari S, Blaivas M, Lyon M. Diagnosis and management of ectopic pregnancy using bedside transvaginal ultrasonography in the ED. The American Journal ofEmergency Medicine. 2007; 48:591-96. 7.Ankum W, Mol B, Van der Veen F, Bossyuyt P. Risk factors for ectopic pregnancy: a meta-analysis. Fertility and Sterility. 1996; 65:1093-99. 8. Barnhardt, K. Ectopic Pregnancy. New England Journal of Medicine. 2009; 361:379-87. 9. Bhatt S, Ghazale H, Dogra V. Sonographic evaluation of ectopic pregnancy. Radiologic Clinics of North America.2007; 45:549-60. 10. Branney S, Wolfe R, Moore E, Albert N. Quantitative sensitivity of ultrasound in detecting free intraperitoneal fluid. The Journal of Trauma. 1995; 39:375-80. 11. Deutchman M, Tubay A, Turok D. First trimester bleeding. American Family Physician. 2009; 79:985-92. 12. Gurel S. Ectopic pregnancy. Ultrasound Clinics. 2008; 3:331-43. 97 13. Jain K. Gynecologic causes of acute pelvic pain: ultrasound imaging. Ultrasound Clinics. 2008; 3:1-12. 14. Lin E, Bhatt S, Dogra V. Diagnostic clues to ectopic pregnancy. Radiographics. 2008; 28:1661-71. 15. Murphy B, Hansen A, Howell J, Simmons B. Critical issues in the initial evaluation and management of patients presenting to the emergency department in early pregnancy. Annals of Emergency Medicine. 2003; 41:123-33. 16. Promes S and Nobay F. Pitfalls in first-trimester bleeding. 2010; 28:219-34. 17. Lozeau AM and Potter B. Diagnosis and Management of Ectopic Pregnancy. Am Fam Physician. 2005 Nov 1;72(9):1707-14 18. Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynecol. Mar 2010;115(3):495-502. 19. Mol BW, Van der Veen F, Bossuyt PM. Implementation of probabilistic decision rules improves the predictive values of algorithms in the diagnostic management of ectopic pregnancy. Hum Reprod. 2009;14:2855–62. 20. Gracia CR and Barnhart KT. Diagnosing ectopic pregnancy: decision analysis comparing six strategies. Obstet Gynecol. 2001;97:464–70. 21. Yip SK, Sahota D, Cheung LP, Lam P, Haines CJ. Accuracy of clinical diagnostic methods of threatened abortion. Gynecol Obstet Invest. 2003:56:38–42.