TITLE:
Epidemiology and Management of Ectopic Pregnancy in Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Southeast, Nigeria
AUTHORS:
Bridget Nkiruka Uche-Nwidagu, Vitus Okwuchukwu Obi, Johnbosco Ifunanya Nwafor, Assumpta Nnenna Nweke, Chinwe Wendy Oliobi, Malachy Chizoba Onyema, Paschal Chijioke Okoye
KEYWORDS:
Epidemiology, Management, Ectopic Pregnancy, Abakaliki
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.9 No.8,
August
28,
2019
ABSTRACT: Background: Ectopic pregnancy is a common cause of maternal morbidity and mortality
in the 1st trimester of pregnancy; without timely diagnosis and
intervention, ruptured ectopic pregnancy can become a life threatening condition. Objective: This study aims to give baseline indices on the incidence, clinical presentation, risk
factors and the management of cases of ectopic pregnancy that presented in Alex
Ekwueme Federal University Teaching Hospital, Abakaliki over a 5-year period. Materials and Method: This is a 5-year retrospective study of patients who were diagnosed with ectopic pregnancy between January 1st 2012 and December 31st 2016. The statistical analysis was done using SPSS version 22. Result: During the study period, there were 11,932 deliveries while 7725 Gynaecology
patients were admitted. Over the same period there were 156 patients diagnosed
and managed for ectopic pregnancy, accounting for 1.31% of all deliveries and
2.0% of all Gynaecological admissions. The
modal age group was 26 - 30 years 68 (43.6%), 122 (78.2%) were married, while 34 (21.7%)
were single. Nulliparous were 41 (26.3%)
and primiparous were 33 (21.2%). The commonest presenting complaints were lower abdominal pain
and amenorrhea, and the commonest identified risk factor was previous pelvic
inflammatory disease. Most of the cases were ruptured prior to presentation and
partial salpingectomy was the management in all tubal pregnancy while two cases
were unruptured and had salpingostomy and another case was abdominal pregnancy
and had exploratory laparotomy only. Out of
156 women that presented with ectopic pregnancy, 8 (5.1%) died before surgery
could be done due to late presentation. Fifty-seven women presented in a state
of shock and 9 (5.8%) of the cases were complicated with acute renal failure. Conclusion: Ruptured ectopic pregnancy is a major
cause of maternal morbidity and early pregnancy loss. Late presentation is a
common feature in our environment; hence widespread advocacy on case identification
and early presentation is urgently needed.