A five-year review of ectopic pregnancy at university of Maiduguri teaching hospital

Back ground: Ectopic pregnancy continues to be a life-threatening gynaecological emergency in our environment.

Objective: This is to determine the epidemiology, risk factors, mode of presentation and management of cases, managed in this centre over a five years period.

Materials and Methods: This is a retrospective study of cases of ectopic pregnancies managed in the gyneacological unit of UMTH Maiduguri from 1st January 2012 to 31st December 2016.

Result: During the period, there were a total of 15,163 deliveries and 3,181 gynaecological admissions in the centre. One hundred and two patients had ectopic pregnancy accounting for 0.7% of all deliveries and 3.2% of all gynaecological admissions. Majority of the patient (47.0%) were between 25-29 years of age, 39.8% attended secondary education and 94.0% were married. Most of the patient (68.7%) were Para 1 to 4. The duration of amenorrhoea ranged between 5-16 weeks and 44.6% of the patient had a period of amenorrhoea of 7-9 weeks. The two most common risk factors in the review were previous abortion (37.3%) and pelvic inflammatory disease (27.7%) but 20.5% of patient did not have any identifiable risk factors. Lower abdominal pain (85.5%) was the commonest symptoms and lower abdominal tenderness (80.7%) was the commonest signs. In 67.1% of the patient, the implantation site was in the ampulla and 59.8% of the patient had ruptured ectopic pregnancy. All the patients were managed by laparatomy and the 30.1% of the patient that were transfused, were given homologous blood.

Conclusion: The rate of ectopic pregnancy in our centre is relatively low. Most of the patients presented with ruptured ectopic pregnancy, hence making tubal conservative treatment inapplicable. Emphasis should be on prevention of common risk factors in our environment, early detection and prompt intervention of ectopic pregnancies so as to give patients opportunities for tubal conservative treatment.