Ectopic pregnancies seen at Nnamdi Azikiwe University Teaching Hospital, Nnewi: (a 5-year review).

Abstract

Background: Ectopic pregnancy is a recognized cause of both maternal mortality and morbidity in early pregnancy and has remained a reproductive health challenge to our women. Highlighting the patients’ characteristics and risk factors as well the management options will aid in improving treatment outcome.
Objective: This is a retrospective study to analyze the clinical profile of patients presenting with ectopic pregnancy at Nnamdi Azikiwe University
Teaching Hospital (NAUTH), Nnewi over a 5- year period. The incidence, risk factors and management options were also reviewed.
Materials and Methods: The case files of all ectopic pregnancies managed in Nnamdi Azikiwe University Teaching Hospital, Nnewi between 1st
June, 2002 and 31st May, 2007 were analyzed.
Results: A total no of 24 cases of ectopic pregnancies were managed, giving an incidence of 0.9% of total births and 4.3 % of all gynaecological
admissions. Majority of the patients (58.3%) were nulliparous while the peak age of incidence was 25-29years. Induced abortions (50.0%) and previous abdominal surgeries (41.7%) were the commonest identified risk factors. Amenorrhea (91.7%), abdominal pain (91.7%) and vaginal bleeding (76.0%) were the most frequent modes of presentation. All patients had ruptured ectopic on presentation and 66.7% of them were in shock at presentation. All patients had laparatomy with salpingectomy and 91.7% of them were transfused. Adhesions were noted in majority (58.3%) of cases. Twelve of the patients (83.3%) suffered post operative morbidities of which anaemia (60.0%) and fever (30.0%) were the commonest. All the surgeries were done by senior registrars and no case mortality was recorded.

Conclusion: The incidence of ectopic pregnancy in the hospital over the period of review was low. Majority of the patients were nulliparous and in
their mid twenties, with a history of induced abortion and previous abdominal surgeries. Post operative morbidity was high, but no mortality was recorded. Pelvic adhesions were noted in majority of cases during surgery and laparatomy with partial salpingectomy was the means of management employed in all cases. Health education addressing healthy sexual behaviours and contraceptive utilization is urgently needed. Efforts should be made to reduce, as much as possible, the risk of adhesions, during pelvic surgeries.