A Re-Evaluation of Ectopic Pregnancies in a Resource-Limited Setting: A Ten Year Review

Abstract

Context: Ectopic pregnancy (EP) is a severe challenge in contemporary gynaecology, particularly in developing economies. Late  presentation and diagnosis increase the associated morbidity and mortality. With the worldwide surge in incidence and varied presentation patterns, re-evaluation has become necessary. This study, therefore, aims at re-evaluating the risk factors and clinical patterns of EP cases in a tertiary health facility in a resource-limited setting.

Settings/Methods/Statistical Analysis: All EP cases managed at the Teaching Hospital of the University of Nigeria (UNTH), Enugu,  Nigeria, from January 1, 2008, to December 31, 2017, were retrospectively evaluated. The collected data was analyzed with the 23.0 edition of Statistical Package for the Social Sciences. Descriptive statistics was done for the qualitative variables. Cross-tabulation was done; the association levels were determined by Chi-square/Fisher’s exact test and Student’s t-test for the qualitative and quantitative variables. P = 0.05 was considered as the statistical significance level.

Results: There were 6448 deliveries and 4129 gynaecological admissions. The mean age of the patients was 29 ± 3 years. Most (76.3%) of the participants (61) were multiparous, whereas only (2) 2.5% of the participants were grand-multiparous. The EP prevalence rate was 1.2% (80 out of 6448), and it constituted 1.9% (80 out of 4129) of all gynaecological  admissions. All the patients presented with ruptured EP. The main presentation of EP among the participants was abdominal pain (69, [86.3%]), while the most presenting risk factor was a history of induced abortion (52, [65%]).

Conclusion: We concluded that ectopic gestation remains a major gynaecological emergency in our environment. Most of our patients had ruptured EP, which could negatively impact our society, which places a high premium on childbearing.

Keywords: Ectopic pregnancy, evaluation, gynaecological emergencies, ruptured, unruptured