Clinical-Demographic Profile and Outcome Assessment of Chronic Ectopic Pregnancy: A Retrospective Study
Authors/Creators
- 1. Senior Resident, Department of Obstetrics and Gynaecology, Vardhaman Mahavir Medical College and Safdarjung Hospital, Delhi, India
- 2. Senior Resident, Department of Obstetrics and Gynaecology, Patna Medical College and Hospital, Patna, Bihar, India
- 3. Consultant, Department of Urology, Satyadev Hospital, Patna, Bihar, India
Description
Abstract
Background: Chronic ectopic pregnancy (CEP) is characterized by low serum HCG levels and tolerance to
methotrexate (MTX) treatment. Histologically, CEP is identified by a compact adnexal mass containing degraded
chorionic villi, areas of necrosis, and multiple blood clots resulting from recurrent small ruptures in the fallopian
tube wall. CEP often manifests as an asymptomatic pelvic mass with low serum hCG levels.
Methods: This retrospective study was conducted at the Department of Obstetrics & Gynaecology, Vardhaman
Mahavir Medical College and Safdarjung Hospital, Delhi, India, for one year. The study enrolled pregnant women
diagnosed with chronic ectopic pregnancies between June 2023 and May 2024. Eligible patients from prenatal
clinics and labour rooms provided written informed consent.
Results: Beta-HCG levels ranged from 3000 to 5000 mIU/ml in 20% of cases, less than 1500 mIU/ml in 3
instances, and over 5000 mIU/ml in 1 case. Haemoglobin levels were between 7 and 10 g/dl across all patients.
The most common sites of ectopic pregnancy were the ampulla (80%) and fimbria (20%). Surgical salpingectomy
was performed in four out of five cases of prolonged ectopic pregnancy. Five patients required blood transfusions:
one unit for 60% (3 cases), two units for 20% (1 case), and three units for another 20% (1 case).
Conclusion: Clinicians should consider persistent ectopic pregnancy as a differential diagnosis in young
multiparous women presenting with abnormal uterine bleeding (AUB) and abdominal pain, especially if
ultrasound reveals a heterogeneous mass in the pouch of Douglas (POD) and/or adnexa without internal
vascularity on color Doppler imaging (CD)
Abstract (English)
Abstract
Background: Chronic ectopic pregnancy (CEP) is characterized by low serum HCG levels and tolerance to
methotrexate (MTX) treatment. Histologically, CEP is identified by a compact adnexal mass containing degraded
chorionic villi, areas of necrosis, and multiple blood clots resulting from recurrent small ruptures in the fallopian
tube wall. CEP often manifests as an asymptomatic pelvic mass with low serum hCG levels.
Methods: This retrospective study was conducted at the Department of Obstetrics & Gynaecology, Vardhaman
Mahavir Medical College and Safdarjung Hospital, Delhi, India, for one year. The study enrolled pregnant women
diagnosed with chronic ectopic pregnancies between June 2023 and May 2024. Eligible patients from prenatal
clinics and labour rooms provided written informed consent.
Results: Beta-HCG levels ranged from 3000 to 5000 mIU/ml in 20% of cases, less than 1500 mIU/ml in 3
instances, and over 5000 mIU/ml in 1 case. Haemoglobin levels were between 7 and 10 g/dl across all patients.
The most common sites of ectopic pregnancy were the ampulla (80%) and fimbria (20%). Surgical salpingectomy
was performed in four out of five cases of prolonged ectopic pregnancy. Five patients required blood transfusions:
one unit for 60% (3 cases), two units for 20% (1 case), and three units for another 20% (1 case).
Conclusion: Clinicians should consider persistent ectopic pregnancy as a differential diagnosis in young
multiparous women presenting with abnormal uterine bleeding (AUB) and abdominal pain, especially if
ultrasound reveals a heterogeneous mass in the pouch of Douglas (POD) and/or adnexa without internal
vascularity on color Doppler imaging (CD)
Files
IJCPR,Vol16,Issue3,Article116.pdf
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Additional details
Dates
- Accepted
-
2024-03-22