Objectives: To determine the seropositivity of Chlamydia antibody
in patients with ruptured ectopic pregnancy compared to normal pregnant women
and the risk factors for ectopic pregnancy. Study Design: This was a
prospective case-control study of 85 cases of ruptured ectopic pregnancy and
100 cases of second trimester on-going intrauterine pregnant controls
presenting in Lagos State University Teaching Hospital (LASUTH) between
September 2009 and March 2010. Study Site: This was at the gynaecological
emergency room and antenatal clinic in the Department of Obstetrics and
Gynaecology. Ethical approval was sought and granted by the ethics review
committee of LASUTH. Study Participants: Patients presenting with ruptured
ectopic pregnancy were recruited as cases while the controls were made up of
those with uncomplicated second trimester intrauterine pregnancy. A
semi-structured questionnaire containing socio-demographic and clinical
characteristics was administered following informed consent. Five milliliters
of venous blood was taken from each participant and tested for Lymphogranuloma
Venerum (LGV) type 2 broadly reacting antigen of Chlamydia trachomatis. Data
Analysis: Data gathered from the case notes and laboratories were imputed into
the computer and analyzed using the statistical package Epi-Info 3.51, Atlanta, USA. Frequency tables were
generated for continuous variables and chi-square
analysis used to determine association between variables, with p values
<0.05 considered statistically significant. Results: There were 91 cases of
ectopic pregnancy among a total of 2468 deliveries giving an incidence of 3.68%
or 1 in 27 deliveries. Factors which significantly contributed to increased
incidence of ectopic pregnancy in this study were: level of education (p =
0.001), socio-economic status (p = 0.001), parity (p = 0.005), early age of
sexual debut (p = 0.001), multiple sexual partners (p = 0.001), previous pelvic
inflammatory disease (p = 0.003), previous induced abortion (p = 0.013) and
previous postabortal/puerperal sepsis (p = 0.013). The
seropositivity of Chlamydia
IgG (62.4%) in the cases was significantly higher than that of 29% in the
control (p < 0.0001). Conclusion: There was a high incidence of ectopic
during the period of study and the seropositivity of Chlamydia IgG antibody was
significantly higher amongst the cases. Risk factors identified were low level
of education, low socio-economic status, low parity, early age of sexual debut,
multiple sexual partners, previous history of pelvic inflammatory disease,
previous induced abortion and previous postabortal/puerperal sepsis.