ABSTRACT
Ectopic pregnancy [EP] is one of the leading causes of maternal mortality. Its frequency in Pakistan is 1:13 pregnancy.1 Tubal ectopic often becomes symptomatic in first trimester by eroding the tubal wall and causing hemorrhage and shock. It is very rare for an ectopic to progress into second trimester and remain asymptomatic2. We are reporting a rare case of tubal ectopic pregnancy which ruptured at 16 weeks of gestation with non-viable fetus. We report a case of 27-year-old female who presented to the emergency of Dr. Zia Uddin Hospital, North Nazimabad, Karachi, with bleeding per vagina and abdominal pain with history of 4 months of amenorrhea. Ultrasound showed 16 weeks fetus in abdomen without cardiac activity and severe hemoperitoneum. She was diagnosed as a case of non-viable, ruptured, tubal ectopic pregnancy of 16-week gestational age. Diagnosis of ectopic pregnancy in first trimester can avert rupture and potential mortality and morbidity. Very few cases of second trimester ectopic pregnancy are reported. The purpose of this case report is to draw the attention for the potential of such incidence in this region and prompt management of such situation.
ABSTRACT
The objectives of the study were to: 1. List the different complications of Grand multipara. 2. Compare the complications of Grand multipara with women of low parity. 3. Compare the fetal outcomes of Grand multipara with women of low parity. Study Design: Cross sectional Setting: Post natal Wards of Gynae unit I, II and III of Abbasi Shaheed Hospital and Sobhraj Maternity Hospital Duration of study: April to Aug 2008 Sample size: 100 Complications in grand multipara had been found in 80% of cases as compared to 20% of women with low parity. Abortion rate was found to be higher in grand multipara [3%] as compared with women of low parity [0%]. Twelve% of newborns were born by breech presentation in grand multipara as compare to just 4% in women of low parity. Regarding the fetal outcome, 5% of grand multipara gave birth to dead newborns as compared to only 1% of women of low parity. Grand multipara had more maternal and fetal complications as compared to women of low parity