Abdominal Pregnancy in Usmanu Dan-Fodiyo University Teaching Hospital, Sokoto: A 10-year Review

Abstract

Background: Abdominal pregnancy, a rare condition with high maternal mortality (up to 50%), and even higher perinatal mortality (40 – 95%), is often associated with diagnostic difficulties.

Objectives: To determine the mode of presentation and management of abdominal pregnancy, from cases in the Usmanu Dan-Fodiyo University Teaching Hospital (UDUTH), Sokoto.

Materials and Methods: A retrospective review of the case records of all abdominal pregnancies managed in UDUTH, Sokoto, between January 2000 and December 2010. Results: During the 10-year study period, there were eight cases of abdominal pregnancies, 285 extrauterine pregnancies, and 25,506 total deliveries. All the patients were not booked for antenatal care and their ages ranged between 20 and 39 years (mean=28.1±3.4 years). The majority (88%) were grand multipara. The main presenting symptoms were persistent abdominal pain, vaginal bleeding, and prolonged pregnancy. Seven cases (87.5%) were diagnosed accurately by an ultrasound scan. There were seven perinatal deaths (87.5%) and one live birth. There was one maternal death (12.5%), which occurred in the patient whose placenta was left in-situ.

Conclusion: Presence of persistent lower abdominal pain, vaginal bleeding, and prolonged pregnancy should raise the suspicion of abdominal pregnancy. Removal of the placenta, where feasible, improves the outcome of maternal health.

Keywords: Ectopic pregnancy, Africa, diagnostic difficulties, maternal mortality