Friday, 28 June 2019

Lupine Publishers-Gynecology Journals

Implantation of pregnancy outside the normal endometrial cavity called an ectopic pregnancy, which accounts for about 10% of all pregnancy-related deaths, despite improved diagnostic methods leading to earlier detection and effective treatment [1]. Also, it increases the chances of secondary infertility as well as incidence of the subsequent ectopic pregnancy [2]. The percentages of the women with ectopic pregnancy go to an emergency department with first trimester bleeding, pain, or both about (6 to 16%) [3]. Which is strongly associated with an increased incidence of pelvic inflammatory disease [4]. Symptoms may present in both ruptured and enraptured cases [5]. Ectopic pregnancy should be suspected in any woman of reproductive age with these symptoms, especially those who have risk factors for an extrauterine pregnancy [6]. The diagnosis is usually made clinically, based upon results of the imaging studies (ultrasound) and laboratory tests (hCG). The diagnosis can also be made by observation of the ectopic gestation at surgery or histopathological examination [7]. Transvaginal ultrasound (TVUS) is the principle approach used for sonographic evaluation of pregnancy of unknown location. TVUS allows for earlier and more reliable detection of an intrauterine or ectopic pregnancy (abdominal pregnancies are an exception) and for more reliable detection of a fetal heartbeat compared with transabdominal ultrasound (TAUS) [7]. A pseudosac can be seen in up to 20 percent of women with an ectopic pregnancy [8]. An extraovarian adnexal mass, seen in 89 to 100 percent of women with ectopic pregnancy, is the most finding in tubal pregnancy.

This is a descriptive, prospective hospital-based study .It was conducted in Omdurman Maternity Hospital and Omdurman New Hospital. Sudan, during the period from August 2014 to Jan 2015 all women diagnosed clinically and by ultrasound with ectopic pregnancy attended study area were included in the study. Time-frame sample size was be taken in a period of six months from August 2014 to Jan 2015. Variables assessed were: sociodemographic data, previous ectopic pregnancy, contraceptive usage, tubal pathology and surgery, PID, clinical presentation, ultrasound findings and intra-operative findings. Intra-operative findings were correlated with clinical presentation, examination, and ultrasound findings. Sensitivity and specificity was calculated. The data was collected by direct interview using predesigned questionnaire. Abdominal ultrasound, and/or vaginal ultrasound were done to all the patients according to clinical presentation. Ultrasound was done by senior obstetrician and radiologist. The data was analyzed by computer program; statistical package for social science (SPPS), results presented in tables and graphs. The test of significance was be calculated by P value (0.05: 95% confidence). Written consent was obtained from SMSB provided to the hospital administration. Women consent was obtained verbally. Privacy of data collected was considered.

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