Ectopic Pregnancies at the Ahmadu Bello University Teaching Hospital, Kaduna, Northern Nigeria
AbstractBackground: Ectopic pregnancy continues to be a major surgical emergency in gynaecology.
Objective: To determine the incidence, clinical pattern, surgical management, morbidity and mortality from ectopic pregnancy in a Nigerian tertiary health care center.
Study Design, Setting and Subjects: The case files of 149 patients who had ectopic pregnancy between 1990 and 1997 at a University Teaching Hospital, were reviewed for biological, social and clinical data.
Results: The frequency of ectopic pregnancy was 1 in 71 deliveries (1.4%). Being married, in the age group 25-29 years, nulliparous and never practiced contraception were found to be risk factors. Abdominal pain (87.2%) and abnormal vaginal bleeding (57.4%) were the commonest symptoms, while circulatory collapse occurred in 10.7% of patients. Diagnostic differentials ranged from acute pelvic inflammatory disease (PID) and threatened abortion to ruptured uterus. Nearly all (96%) of the gestational sacs were ruptured before presentation. In 97 (67%) of the patients, there was macroscopic evidence of PID. More than 90% of the pregnancies were tubal, with 88% of these being located in the ampulla. Abdominal pregnancy occurred in 4 patients. Unilateral partial salpingectomy was done in 104(69.79%) patients, and 2 live mature fetuses were delivered at laparotomy. One maternal death occurred among the patients.
Conclusion: The frequency of ectopic pregnancy is still high in this environment. Early presentation, high index of suspicion and use of modern diagnostic techniques will improve overall clinical outcome in patients. Promotion of family planning, early treatment of PID and good quality obstetric care could be important preventive intervention measures.
(Tropical Journal of Obstetrics and Gynaecology: 2001, 18(2): 82-86)
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