Evaluation of ectopic pregnancy in Al- Salam hospital in Mosul, Iraq

Authors

  • Sada Azawi Yahya Al- Salam hospital, Mosul Health Directorate, Mosul, Iraq.

DOI:

https://doi.org/10.22317/imj.v4i1.772

Abstract

Objective: This study aimed to evaluate the ectopic pregnancy in Mosul city.

Methods: A cross sectional study in which 88 females attended to Al- Salam hospital in Mosul city from 2017 - 2019. All females with current ectopic pregnancy included and any women with no EP has been excluded.

Results: mean age (28.7 ± 6) years old, 59% of females at age group 21 – 30 years old 27% of them at age group 31 – 40 years old and 10 % in age group 11 – 20 years old, the main complain of females: abdominal pain (31.8%), abdominal pain and bleeding (23.9%), irregular bleeding (17%) and other complain. Type of infertility of females: no infertility (61.4 %), primary (21.6 %) and secondary (17.0%). 45.5 % of females had infection and all females history of operation was ovarian cyst (6.8%), appendicitis (11.4 %), ART (13.6%) and 55.7% of them with no any history of previous operation. 86% of females get pregnancy by normal ways and 14% get by IVF. 97% of females with no history of previous EP. 14% of them use contraception ( pills 3%, IUCDS 7%, injectable 4%). 37.5% of females in our study with no baby while 24% with 1 baby and 19% with 2 and above 3 babies respectively. 35% of females with history of previous abortion ( 24% 1 abortion, 8% 2 abortion, 2% 3 abortion and 1% 4 abortion). 91% of females with destruction of fallopian tube (53% left side, 43% right side and 4% other part). 98% of females with surgical treatment (Salpingectomy) while other 2% of them treated as medical treatment.

Conclusion: There are increase in incidence of EP and decrease in mother death, main manifestations are abdominal pain, abdominal pain and bleeding and irregular bleeding so early diagnosis of females lead to decrease mortality and rapid surgical intervention decrease mortality and complication.

References

1. Panti, A. et al. Ectopic pregnancy at Usmanu Danfodiyo University Teaching Hospital Sokoto: A ten year review. Annals of Nigerian Medicine 6, 87 (2012).
2. Kharat, D., Goswami Giri, P. & Fonseca, M. A study of epidemiology of ectopic pregnancies in a tertiary care hospital of Mumbai, India. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 6, 3942 (2017).
3. Padubidri, VG. Daftary, SN. Shaw’s textbook of gynaecology (16th edition). Shaw’s textbook of gynaecology 1, 567 (2015).
4. Migda, M., Migda, M., Maleńczyk, M. & Wender-Ozegowska, E. Heterotopic pregnancy in the absence of risk factors - Diagnostics difficulties. Ginekologia Polska 82, 866–868 (2011).
5. Constance, E. S. & Moravek, M. B. in Handbook of Gynecology 1, 291–304 (Springer International Publishing, 2017).
6. Rackova J, Driak D, Neumannova H, Hurt K, Sehnal B, Halaska M. [Use of methotrexate in the ectopic pregnancy and pregnancy of unknown location]. Ces Gynekol. 2016 Apr;81(2):140–6.
7. Nowak-Markwitz E, Michalak M, Olejnik M, Spaczynski M. Cutoff value of human chorionic gonadotropin in relation to the number of methotrexate cycles in the successful treatment of ectopic pregnancy. Fertil Steril. 2009 Oct;92(4):1203–7.
8. Little SH, Rockwell PG. Ectopic pregnancy: zero in on these lab and imaging clues. J Fam Pract. 2012 Nov;61(11):678–86.
9. Lu Q, Wang Y, Sun X, Li Y, Wang J, Zhou Y, et al. The diagnostic role of the beta-hCG discriminatory zone combined with the endometrial pattern for ectopic pregnancy in Chinese women. Sci Rep. 2019 Sep;9(1):13781.
10. Mann LM, Kreisel K, Llata E, Hong J, Torrone EA. Trends in Ectopic Pregnancy Diagnoses in United States Emergency Departments, 2006-2013. Matern Child Health J. 2020 Feb;24(2):213–21.
11. Wakankar, R. & Kedar, K. Ectopic Pregnancy -A rising Trend. International Journal of Scientific Study 3, (2015).
12. Tahmina, S., Daniel, M. & Solomon, P. Clinical analysis of ectopic pregnancies in a tertiary care centre in Southern India: A six-year retrospective study. Journal of Clinical and Diagnostic Research 10, QC13–QC16 (2016).
13. Shetty VH, Gowda S, Muralidhar L. Role of ultrasonography in diagnosis of ectopic pregnancy with clinical analysis and management in tertiary care hospital. J Obstet Gynaecol India. 2014 Oct;64(5):354–7.
14. Jacob, L., Kalder, M. & Kostev, K. Risk factors for ectopic pregnancy in Germany: A retrospective study of 100,197 patients. GMS German Medical Science 15, (2017).
15. Li C, Zhao W-H, Zhu Q, Cao S-J, Ping H, Xi X, et al. Risk factors for ectopic pregnancy: a multi-center case-control study. BMC Pregnancy Childbirth. 2015 Aug;15:187.
16. Gaskins AJ, Missmer SA, Rich-Edwards JW, Williams PL, Souter I, Chavarro JE. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertil Steril. 2018 Dec;110(7):1328–37.
17. Xi Q, Yu Y, Zhang X, Zhang H, Jiang Y, Liu R, et al. Two cases of intrauterine pregnancy with tubal stump pregnancy after in vitro fertilization and embryo transfer following ipsilateral salpingectomy: A case report. Medicine (Baltimore). 2019 Dec;98(49):e18183.
18. Chen X-L, Chen Z-R, Cao Z-L, Han K, Tong Y-W, Xiang X-H, et al. The 100 most cited articles in ectopic pregnancy: a bibliometric analysis. Springerplus. 2016;5(1):1815.
19. Moini, A., Hosseini, R., Jahangiri, N., Shiva, M. & Akhoond, M. R. Risk factors for Ectopic Pregnancy: A case-control study. Journal of Research in Medical Sciences 19, 844–849 (2014).
20. Santos-Ribeiro S, Tournaye H, Polyzos NP. Trends in ectopic pregnancy rates following assisted reproductive technologies in the UK: a 12-year nationwide analysis including 160 000 pregnancies. Hum Reprod. 2016 Feb;31(2):393–402.
21. Constance ES, Moravek MB. Diagnosis and management of ectopic pregnancy. Handb Gynecol. 2017;1(6):291–304.
22. Patel, S., & Desai, A. (2019). Study of diagnosis and management of ectopic pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8(6), 2465-2470.
23. Igwegbe, A., Eleje, G. & Okpala, B. An appraisal of the management of ectopic pregnancy in a Nigerian tertiary hospital. Annals of Medical and Health Sciences Research 3, 166 (2013).
24. Pusuloori, R. & Arora, K. D. A comparative study of ectopic pregnancy at a tertiary care centre. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, 694 (2018).
25. Murray, H., Baakdah, H., Bardell, T. & Tulandi, T. Diagnosis and treatment of ectopic pregnancy. CMAJ 173, 905–912 (2005).
26. Majhi AK, Roy N, Karmakar KS, Banerjee PK. Ectopic pregnancy--an analysis of 180 cases. J Indian Med Assoc. 2007 Jun;105(6):308, 310, 312 passim.
27. Kharat D, Goswami Giri P, Fonseca M. A study of epidemiology of ectopic pregnancies in a tertiary care hospital of Mumbai, India. Int J Reprod Contraception, Obstet Gynecol. 2017;6(9):3942.
28. Bouyer, J. et al. Risk factors for ectopic pregnancy: A comprehensive analysis based on a large case-control, population-based study in France. American Journal of Epidemiology 157, 185–194 (2003).
29. Mimoun, C., Fauconnier, A., Varas, C. & Huchon, C. Is a self-assessed questionnaire useful for the diagnosis of ectopic pregnancy in hospitalized patients? PLoS ONE 11, (2016).

Downloads

Published

2020-03-26

How to Cite

Yahya, S. A. (2020). Evaluation of ectopic pregnancy in Al- Salam hospital in Mosul, Iraq. Iraq Medical Journal, 4(1). https://doi.org/10.22317/imj.v4i1.772

Issue

Section

Articles