Ectopic pregnancy experience in a tertiary health facility in South-South Nigeria

Abstract

Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria.

Objective: To determine the incidence, clinical presentation, risk factors and management outcomes of ectopic pregnancies in a tertiary health facility.

Methods: A retrospective study of all cases of ectopic pregnancies managed at the University of Port Harcourt Teaching Hospital (UPTH) from January 1, 2011 to December 31, 2015 was conducted. Data collected with the aid of data-entry forms designed for this purpose were analyzed using statistical package SPSS 20.

Results: There were 2,579 gynecological admissions and 12,421 deliveries, with 414 cases of ectopic pregnancies managed. Ectopic pregnancy constituted 16.1% of all gynecological admissions, and its incidence was 3.3%. A total of 345 cases were suitable for analysis. The mean age of the patients was 27.9 ± 5 years. 330 women (95.7%) had ruptured ectopic pregnancies, and the remaining fifteen (4.3%) were unruptured. The commonest clinical presentation were abdominal pain and amenorrhoea in 99.7%. The commonest identified risk factor was a previous history of induced abortion in 328 women (95.1%). Two deaths were recorded, giving a case-fatality rate of 0.6%.

Conclusion: Majority of the patients presented with ruptured ectopic pregnancy. This has adverse effect in a society that places a high premium on child bearing. Early diagnosis, identifying of risk factors and timely intervention in the form of medical or surgical treatment will go a long way in reducing the morbidity and mortality associated with ectopic pregnancy.

Keywords: Ectopic pregnancy, amenorrhea, abdominal pain, case fatality, ruptured ectopic