Ectopic Pregnancy: Reasons for the High Tubal Rupture Rates in a Nigerian Population
Context: Nigeria has a high incidence of ruptured ectopic pregnancy. Identification of predisposing factors will help reduce morbidity and mortality
Aim: To determine the reasons for the high incidence of ruptured ectopic pregnancy.
Methods: All cases of ectopic pregnancies managed at Wesley Guild Hospital, Ilesha, Nigeria , between January 2004 and December 2008 were the subjects of this study. The case notes were reviewed to obtain information on the socio demographic characteristics of the patients, clinical history and operative findings.
Results: Of the 1,048 gynaecological admissions during the study period 98(9.4%) were for ectopic pregnancy out of which76(96.2%) were ruptured The mean age of the patients was 28.3 years (SD=5.1), majority (82.3%) were married and 68.4% have had one or more previous deliveries.
Amenorrhea was present in 66(83.5%). Abdominal pain (98.%), dizziness (62.0%) and vaginal bleeding (44.3%) were the commonest symptoms. Only 30 (38.0%) presented to any medical facility within 24 hours of the onset of symptoms. The ectopic was tubal in 67(84.8%), abdominal in one and could not be specified in 11. Of the tubal pregnancies ampulla (49.3%), cornual (25.4%) and isthmus (15..0%) were the commonest sites. All patients had laparotomy and salpingectomy. There was no maternal death.
Conclusion In our community ectopic pregnancy tends to occur more often in parous women and are more commonly located in the isthmio cornual part of the tube. Besides, majority of our women present late making them more vulnerable to ruptured ectopic pregnancy.
Key Words: Ectopic, Pregnancy, Complications, Presentation.
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