Abstract
Introduction
Predominant etiology of ectopic gestation is tubal damage, notably salpingitis, which may be of tubercular etiology.
Aims and objectives
To compare the incidence of genital tuberculosis (GTB) in two groups of adolescent patients: one undergoing surgery for acute ectopic pregnancy, the other undergoing suction evacuation for spontaneous miscarriage and to evaluate GTB as a risk factor for ectopic pregnancy in adolescent girls from low socioeconomic status presenting to a tertiary care hospital in Northern India.
Materials and methods
Prospective case–control study with 17 adolescent subjects from low socioeconomic status with acute presentation of ectopic pregnancy (group 1, study) undergoing laparotomy with 20 adolescent subjects with spontaneous miscarriage (group 2, control) undergoing suction evacuation. Subjects were tested for presence of GTB by presence of tubercular granuloma and/or positive growth on BACTEC radiometric assay from sample obtained from endometrial aspirate and products of conception in groups 1 and 2, respectively.
Results
Incidence of GTB was 35.29 % (6 out of 17) in the study group compared with 5 % in the control group (1 out of 20) (P = 0.03).
Conclusion
The sample size of this pilot study is too small to arrive at the definite conclusion whether GTB is risk factor for acute ectopic in this population of patients. Larger studies are needed to validate this hypothesis. However, in the presence of risk factors/suggestive intraoperative findings, testing for TB in this set of population presenting with ectopic pregnancy may be justified to prevent further morbidity by initiating anti-tubercular therapy in high prevalence areas.
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References
Chhabra S, Sirohi RJ (2004) Trends in maternal mortality due to haemorrhage: two decades of Indian rural observations. J Obstet Gynaecol 24(1):40–43
Barnhart KT, Sammel MD, Gracia CR et al (2006) Risk factors for ectopic pregnancy in women with symptomatic first trimester pregnancies. Fertil Steril 20:1
Zane SB, Kieke BA Jr, Kendrick JS et al (2002) Surveillance in a time of changing health care practices: estimating ectopic pregnancy incidence in the United States. Matern Child Health J 6:227
Marion LL, Meeks GR (2012) Ectopic pregnancy: history, incidence, epidemiology, and risk factors. Clin Obstet Gynecol 55(2):376–386
TB India Revised National TB Control Programme (RNTCP) (2012) Annual report March 2012. Central TB Division, Directorate General of Health Services, Ministry of Health and Family Welfare, New Delhi. http://www.tbcindia.nic.in
Varma TR (1991) Genital tuberculosis and subsequent fertility. Int J Gynecol Obstet 35:1–11
Bazaz Malik G, Maheshwari B, Lal N (1983) Tuberculous endometritis: a clinicopathological study of 1000 cases. Br J Obstet Gynaecol 90:84–86
The State of the World’s Children (2006) UNICEF, UNICEF House, 3 UN Plaza, New York, USA. http://www.unicef.org/sowc06/pdfs/sowc06_fullreport.pdf
Statistics on Women in India (2010) National Institute of Public Cooperation and Child Development, NIPCCD, 2010. http://nipccd.nic.in/reports/ehndbk10.pdf
WHO Library cataloguing-in-publication data: mental health policy and service guidance package: child and adolescent mental health policies and plans
Babu D, Nidhi NP, Verma RK (1998) Miscarriage in India: What does the National Family Health Survey tell us? J Family Welfare 44(4): 45–54
Alexander R, Mathai E, Nayyar V, Mathew M, Jasper P (1993) Low prevalence of chlamydial endocervical infection in antenatal south Indian women. Genitourin Med 69(3):240–241
Malik A, Jain S, Hakim S, Shukla I, Rizvi M (2006) Chlamydia trachomatis infection and female infertility Indian J Med Res 123:770–775
Brabin L, Gogate A, Gogate S, Karande A, Khanna R et al (1998) Reproductive tract infections, gynaecological morbidity and HIV seroprevalence among women in Mumbai, India. Bull World Health Organ 76(3):277–287
Screening for Chlamydia infection in pregnancy UK National Screening Committee 10 March 2011. http://www.screening.nhs.uk/policydb_download.php?doc=125
CDC chlamydial infections 2010 STD treatment guidelines. http://www.cdc.gov/std/treatment/2010/chlamydial-infections.htm
Neonakis IK, Spandidos DA, Petinaki E (2011) Female genital tuberculosis: a review. Scand J Infect Dis 43(8):564–572
Kulshrestha V, Kriplani A, Agarwal N, Singh UB, Rana T (2011) Genital tuberculosis among infertile women and fertility outcome after antitubercular therapy. Int J Gynaecol Obstet 113(3):229–234
Sharma JB (2008) Tuberculosis and obstetric and gynecological practice. In: Studd J, Tan SL, Chervenak FA (eds) Progress in obstetrics and gynecology, 18th edn. Elsevier, Edinburgh, pp 395–427
Bhanu NV, Singh UB, Chakraborty M et al (2005) Improved diagnostic value of PCR in diagnosis of female genital tuberculosis leading to infertility. J Med Microbiol 54:927–931
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Banerjee, A., Prateek, S., Malik, S. et al. Genital tuberculosis in adolescent girls from low socioeconomic status with acute ectopic pregnancy presenting at a tertiary care hospital in urban Northern India: are we missing an opportunity to treat?. Arch Gynecol Obstet 286, 1477–1482 (2012). https://doi.org/10.1007/s00404-012-2487-z
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DOI: https://doi.org/10.1007/s00404-012-2487-z