Ectopic Pregnancy Case Studies

Abstract-

Introduction- Ectopic pregnancy is one of the leading causes of maternal mortality and morbidity in the first trimester. It is estimated that worldwide around 10-15% of maternal deaths in first trimester are contributed by ectopic pregnancy. Here I, discuss a case of young lady with culture positive UTI having ruptured ectopic pregnancy.

Case presentation- Mrs. A, 30 year old admitted to a medical ward with lower abdominal pain and urinary symptoms and found to have culture positive UTI.She was started on IV broad spectrum antibiotics and improved subsequently. On the day of discharge she collapsed while going to the washroom.

On examination she found to haemodynamically unstable with low Hemoglobin of 5.8 and positive urine Beta-HCG,

Despite this, morbidity and mortality attributable to failure to consider the diagnosis, and therefore missed or delayed diagnosis, continues to be problematic. This is often due to misconceptions and ignorance of symptoms and signs of an ectopic pregnancy. The incidence rates vary among different countries. In developing countries, the incidence rates vary from 1in 44 deliveries to 1 in 21 deliveries, while in the developed western countries, the rates are between 1 in 233 and 1 in 280 deliveries. Mean while ectopic pregnancy is a leading cause of maternal mortality and morbidity.

The incidence of ectopic pregnancy was thought to be rising..The causes for the rising trend are multifactorial, including more liberal sexual practices and an ever increasing incidence of pelvic inflammatory disease.

In the developed countries, the detection rates for unruptured ectopic pregnancy ranges from 88% to 100%, compared to developing countries which is far more less. Classically ectopic pregnancy presents with abdominal pain and vaginal bleeding between 6-10 weeks of

This prevents life-threatening hemorrhagic shock, excessive tubal damage and blood transfusion. Symptoms of dizziness, syncope, and shock are late signs suggestive of ruptured ectopic pregnancy. Her main symptoms were colicky lower abdominal pain, with urinary symptoms. The location, nature, and severity of pain with ectopic pregnancy may be pelvic or abdominal, unilateral or bilateral, localized, dull, sharp, cramping, intermittent or continuous. Colicky pain presents mainly in the hypogastric or iliac regions and is most likely due to small-volume intraperitoneal hemorrhage. Localized abdominal or pelvic pain is caused by acute distension of the fallopian tube at the site of trophoblast implantation. Tubal rupture is typically associated with a longer-lasting, more generalized pain due to hemoperitoneum,but rupture may also be associated with a decrease in or resolution of pain altogether. Pain referred to the shoulder, indicating irritation of diaphragm is late