Rsrchkasa

by Fouzia
(S A)

Original Text: Rsrchkasa

Ectopic pregnancy remains a major cause of maternal morbidity and mortality despite advances in diagnostic and therapeutic tools (19). In our study, one fifth of the cases presented with ruptured ectopic.

Clinically the diagnosis of ectopic pregnancy is not always straightforward. In this study, only 87.9% were a definite diagnosis based on the recognized clinical features, ultrasound and laboratory findings.

The dilemma remains that the majority of cases present with no risk factors and have an atypical presentation (20). In this study, 71% of the patients presented with no risk factors. Only 5.8% presented with previous ectopic while 3.8% presented with a history of induction ovulation. One third of the patients presented with acute abdomen.

The diagnosis is usually made clinically based upon results from ultrasound in correlation with human chorionic gonadotropin hormone (hCG) testing. Confirmation of the diagnosis by visualization at surgery or histopathological examination of tissue is unnecessary. However, in the absence of definitive surgical, sonographic, or histopathological findings, it may not be possible to differentiate between a failed intrauterine pregnancy and an ectopic pregnancy.

Diagnosis was mainly made by ultrasound where 80% had no intrauterine gestational sac; presence of complex adnexal masses was in 75% of the cases with moderate to large amounts of fluid in the pouch of Douglas in 30.8% of the cases.

The most significant findings for ectopic pregnancy is the presence of live extra uterine pregnancy, found only in 3 % to 26% of cases of ectopic pregnancy. Patients within the reproductive age presenting with abdominal pain, amenorrhea and vaginal bleeding should be suspected for ectopic pregnancy, especially those with risk factors for extra uterine pregnancy.

In clinically stable patients with low B hCG, conservative management could be an acceptable option. 6 patients with (mean B hCG 955.5 IU/L) were treated successfully by conservative management. This modality should not be adapted except under strict criteria with close observation of the patient since it’s difficult to predict uncomplicated spontaneous resolution

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Revised Text:

Ectopic pregnancy remains a major cause of maternal morbidity and mortality, despite advances in diagnostic and therapeutic tools (19). In our study, one fifth of the cases presented with ruptured ectopic.

Clinically, the diagnosis of ectopic pregnancy is not always straightforward. In this study, only 87.9% of the cases were a definite diagnosis based on the recognized clinical features; ultrasound and laboratory findings.

The dilemma remains that the majority of cases present with no risk factors and have an atypical presentation (20). In this study, 71% of the patients presented with no risk factors. Only 5.8% presented with previous ectopic, while 3.8% presented with a history of induction ovulation. One third of the patients presented with acute abdomen.

The diagnosis is usually made clinically, based upon results from ultrasound in correlation with human chorionic gonadotropin hormone (hCG) testing. Confirmation of the diagnosis, by visualization at surgery or histopathological examination of tissue, is unnecessary. However, in the absence of definitive surgical, sonographic, or histopathological findings, it may not be possible to differentiate between a failed intrauterine pregnancy and an ectopic pregnancy.

Diagnosis was mainly made by ultrasound, where 80% had no intrauterine gestational sac. Complex adnexal masses were present in 75% of the cases, with moderate to large amounts of fluid in the Pouch of Douglas in 30.8% of the cases.

The most significant findings for ectopic pregnancy is the presence of live extra uterine pregnancy, found only in 3% to 26% of cases of ectopic pregnancy. Patients within the reproductive age presenting with abdominal pain, amenorrhea and vaginal bleeding should be suspected for ectopic pregnancy, especially those with risk factors for extra uterine pregnancy.

In clinically stable patients with low B hCG, conservative management could be an acceptable option. Six patients with mean B hCG 955.5 IU/L, were treated successfully by conservative management. This modality should not be adopted, except under strict criteria with close observation of the patient, since it’s difficult to predict uncomplicated spontaneous resolution.

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