Pattern and Outcome of Ectopic Pregnancy in a Tertiary Health Center, Sagamu, Nigeria: a Re-visit and a Six-year Review

Abstract

The objective of this study was to determine the demographic characteristics, the incidence, mode of presentation, diagnosis, treatment and outcome of patients with ectopic pregnancy in OOUTH, Sagamu, Nigeria. This was a retrospective study of all the cases of ectopic pregnancy managed at OOUTH, Sagamu from July 1 2007 to June 30, 2013. The case notes were retrieved from the medical information department, data extracted and analyzed with SPSS version 16.0 software programme. During the period of the study, there were 71 cases of ectopic pregnancy out of 3505 deliveries giving an incidence of 2% and accounted for 5.9% of all gynaecological admissions. Sixty-eight case notes were available for analysis. The commonest finding at presentation was abdominal tenderness which occurred in 97.1% of the patients. There were identifiable risk factors in 82.4% of the patients. Diagnosis was made with a combination of clinical findings, abdominal ultrasound scanning and pregnancy test in 57.4% of the patients. Majority of the patients (91.2%) presented with ruptured ectopic and were treated as an acute emergency. All the cases had laparotomy with radical tubal surgery as there were no indications for conservative surgery. The commonest site of the ectopic was the ampullary region of the tube (54.4%) and about 44.2% of the patients had no blood transfusion. There was only one maternal death resulting in a case fatality rate of 1.5%. The need for early presentation (when ectopic pregnancy has not ruptured and patient is haemodynamically stable) should be advocated as this will facilitate conservative management and fertility preservation.

Key words: Ectopic pregnancy, emergency care, risk factors, reproductive health, maternal mortality, exploratory laparotomy, Nigeria.