Abstract
Background: Ectopic tubal pregnancy (ETP) is a dreadful situation for both the patient and the doctor. Prevalence of ETP is increasing because of availability of convenient and modern modalities for the diagnosis of ectopic pregnancy. Patients are aware of the condition and many lives can be saved when diagnosed and managed at an early stage; still almost 10% of maternal deaths are due to ETP. The etiology of ETP remains unknown in almost half of the cases and hence the risk of recurrence remains high. The present study has been conducted to screen patients with history of tubal ectopic pregnancyand to determine the role of tubercular infestation of the eutopicendometrium as an important etiological factor in ‘unexplained’ ectopic. Results: This retrospective analysis was conducted at Calcutta Fertility Mission in Kolkata, India, from January 2010 to December 2018. Of 282 patients with history of ETP,who were selected, 109 were in Group A, 72 of them in Group B and 101 in Group C. Tubercular infestation of the endometrium (DNA-PCR positive) was found in all (109) patients in Group A, and others in Group B and C had previous history of pelvic surgery or endometriosis, pelvic infection or unexplained infertility associated with tubercular infestation of the endometrium. In our study latent genital tuberculosis has been proved to be a statistically significant factor for ETP. (p value - <0.001) Moreover other factors like tubal surgeries (p value - <0.001) or correction of minor tubal defects (p value – 0.024); endometriosis (p value- <0.001) and pelvic inflammatory disease (p value -<0.001), have shown statistical significance in causing ectopic pregnancy. Clinical pregnancy rate (p value -0.002) and live birth rate (p value-<0.001) has been proved to be statistically significant after treatment of ETP. Conclusion: Along with the documented causes of ETP tubercular infestation of the endometrium should be considered as an important etiology for ectopic pregnancy and should be screened on a routine basis for early intervention and treatment.
Highlights
Ectopic tubal pregnancy (ETP) is a dreadful situation for both the patient and the doctor
The present study has been conducted to screen patients with history of tubal ectopic pregnancyand to determine the role of tubercular infestation of the eutopicendometrium as an important etiological factor in ‘unexplained’ ectopic
Early intervention saves lives and reduces morbidity, but ectopic pregnancy still accounts for 4% to 10% of maternal deaths and leads to a high incidence of ectopic site gestations in subsequent pregnancies.[1]Several risk factors for ETP have been documented including age,sociodemographic characteristics, reproductive history (multiple sexual partners, pelvic inflammatory disease (PID), Chlamydia trachomatis infection, certain forms of contraception, smoking, DES exposure, endometriosis, utero-tubal anomalies and treatment for infertility. [2]In about 50% cases the etiology of ETP remains uncertain and the risk of recurrence remains high. [3]In the present study patients with history of tubal ectopic pregnancywere evaluated to determine role of tubercular bacilli infestation of endometrium as an important etiological factor
Summary
Ectopic tubal pregnancy (ETP) is a dreadful situation for both the patient and the doctor. The present study has been conducted to screen patients with history of tubal ectopic pregnancyand to determine the role of tubercular infestation of the eutopicendometrium as an important etiological factor in ‘unexplained’ ectopic. Conclusion: Along with the documented causes of ETP tubercular infestation of the endometrium should be considered as an important etiology for ectopic pregnancy and should be screened on a routine basis for early intervention and treatment. Early intervention saves lives and reduces morbidity, but ectopic pregnancy still accounts for 4% to 10% of maternal deaths and leads to a high incidence of ectopic site gestations in subsequent pregnancies.[1]Several risk factors for ETP have been documented including age,sociodemographic characteristics, reproductive history (multiple sexual partners, pelvic inflammatory disease (PID), Chlamydia trachomatis infection, certain forms of contraception, smoking, DES exposure, endometriosis, utero-tubal anomalies and treatment for infertility. Early intervention saves lives and reduces morbidity, but ectopic pregnancy still accounts for 4% to 10% of maternal deaths and leads to a high incidence of ectopic site gestations in subsequent pregnancies.[1]Several risk factors for ETP have been documented including age,sociodemographic characteristics, reproductive history (multiple sexual partners, pelvic inflammatory disease (PID), Chlamydia trachomatis infection, certain forms of contraception, smoking, DES exposure, endometriosis, utero-tubal anomalies and treatment for infertility. [2]In about 50% cases the etiology of ETP remains uncertain and the risk of recurrence remains high. [3]In the present study patients with history of tubal ectopic pregnancywere evaluated to determine role of tubercular bacilli infestation of endometrium as an important etiological factor
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
