Review Article
Year: 2021 | Month: March | Volume: 11 | Issue: 3 | Pages: 128-135
Ectopic Pregnancy: A Review of Clinical Presentation and Management in Niger Delta University Teaching Hospital, Bayelsa State Nigeria
Eugene M. Ikeanyi1, Howells E. Ikobho2
1,2Department of Obstetrics and Gynecology, Niger Delta University Teaching Hospital Okolobiri, Bayelsa State, Nigeria
Corresponding Author: Eugene M. Ikeanyi
ABSTRACT
Background: Ectopic pregnancy poses a major health and reproductive challenge to childbearing women. It is a significant hemorrhagic disorder that continues to contribute substantially to maternal morbidity and mortality. This is an error of zygote implantation outside the endometrial cavity with consequent rupture and or death of the fetus because of the failure of implantation site to sustain further fetal growth and development. Unless timely interventions, the consequences of ruptured ectopic pregnancy can be life-threatening.
Objectives: To measure the incidence of ectopic pregnancy in the Niger Delta University Teaching Hospital, determine its contribution to early pregnancy loss, case-fatality rate and investigate the possible associated risk factors and other relevant correlates.
Methods: Data on each ectopic pregnancy that presented from 2015 to 2020 were collected and analyzed.
Results: Ectopic pregnancy constituted 6.3% and 23.9% of gynaecological admissions and surgeries respectively and an incidence of 2.8% of live births and 2.3% of all pregnancies managed. Median age of patients was 29 (interquartile 25-34) years, the leading identifiable risk factors were previous induced abortion (72.7%), intra-abdominal surgery (23.6%) and multiple sex partners (21.5%). The commonest clinical presentation were abdominal pain (96.4%), dizziness/fainting spell (58.2%) and vaginal bleeding (41.8%). Mean estimated blood loss was 1593.6±702.8mls, 85.5% of the patients were anemic at presentation and 89.1% received blood transfusion. Tubal pregnancy was 94.5%, left tube 51.9%, ampullary 69.2% and isthmic 17.3%. All the patients had laparotomy, 92.7 % salpingectomy (49.1% left and 43.6% right). There was one death; a case fatality of 1.56%.
Conclusion: Ectopic pregnancy still remains a major cause of maternal morbidity and mortality. Prior tubal damage, mostly from pelvic infection is the risk factor. Quality contraception, blood banking services and legalization of abortion will mitigate the impact of ectopic pregnancy
Key words: ectopic, pregnancy, incidence, salpingectomy, case-fatality, risk factor.