印度西孟加拉邦班库拉某三级医学院和医院异位妊娠的etio病理、社会经济分布和临床影像的横断面观察研究

Anirban Talukder, Sougata Kumar Burman, Gairik Bera, Jayeeta Mukherjee, Mousumi Maji, Debojyoti Santra
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引用次数: 0

摘要

背景:异位妊娠或胚胎异常着床是全世界育龄妇女死亡和发病的主要原因之一。早期诊断和及时干预可有效避免其严重后果。本研究旨在确定异位妊娠的发生率、易感的社会经济因素和病因病理学,并评估异位妊娠的各种临床表现和治疗方式。方法:于2015年4月1日至2016年3月31日在班库拉市BSMCH妇产科进行观察性横断面调查。纳入100例经知情同意后经临床或超声确认的异位妊娠患者,收集数据并进行分析。结果:68%的患者年龄在21 ~ 30岁之间,80%的患者社会经济地位较低,69%为多胎。检测到的典型危险因素有盆腔炎史、流产史和输卵管手术史。最一致的临床特征是下腹部疼痛(98%),其次是闭经(90%)和阴道出血(82%)。97%的患者表现为面色苍白,23%的患者表现为休克。73%的患者临床可引起颈椎运动压痛,95%的患者可在超声心动图中发现附件肿块。所有患者尿妊娠试验阳性,右侧是最常见的受累侧(53%)。所有患者均行手术干预。结论:从病史、临床特征、超声心动图等方面及时发现并及时处理是提高产妇生存率和保存生殖能力的重要手段。关键词:异位妊娠,UPT, PID,输卵管手术,附件肿块,POD液体,壶腹
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A Cross-sectional Observational Study of the Etio-pathology, Socioeconomic Distribution and Clinical Pictures of Ectopic Pregnancy in a Tertiary Medical College and Hospital in Bankura, West Bengal, India
Background: Ectopic pregnancy or abnormal implantation of embryo is one of the foremost causes of mortality and morbidity in women of reproductive age worldwide. Its serious consequences can be effectively averted by early diagnosis and timely intervention. This study aimed at determining the incidence, predisposing socio-economic factors and etiolo-pathology, and assessment of various clinical manifestations and treatment modalities of ectopic pregnancy. Methods: This observational cross- sectional survey was conducted in the department of obstetrics and gynaecology BSMCH, Bankura from 1.4.2015 to 31.3.2016. It included 100 patients with admitted with clinically or sonologically confirmed ectopic pregnancy after informed consent, data was collected and analysed thereafter. Results: It was observed that 68% of the cases belonged to 21-30 years of age, 80% with low socio-economic status, 69 % comprised of multigravidas. The typical risk factors detected were history of PID, abortion and previous tubal surgery. The most consistent clinical feature was pain in lower abdomen (98%) followed by amenorrhoea (90%) and vaginal bleeding (82%). 97% of the patients presented with pallor and 23% with shock. In 73% patients cervical motion tenderness could be elicited clinically and adnexal mass in USG was found in 95 %. Urine pregnancy test was positive in all patients and right side was the commonest side of involvement (53%). All the patients underwent surgical intervention. Conclusion: Prompt detection from history, clinical features, USG and appropriate and well-timed management are of utmost importance to enhance better maternal survival and conservation of reproductive capacity. Keywords: Ectopic pregnancy, UPT, PID, Tubal surgery, Adnexal mass, POD fluid, Ampulla
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