Ectopic Pregnancies in a Tertiary Hospital in Nigeria: A 10-Year Retrospective Experience

Emmanuel C. Egwuatu¹, Chigozie G. Okafor^1, , George U. Eleje^{1, 2}, Osita S. Umeononihu^{1, 2}, Chukwuemeka C. Okoro¹, Jonhnbosco E. Mamah³, Tobechi K. Njoku¹, Charlotte B. Oguejiofor^{1, 2}, Chidinma C. Okafor⁴, Chukwunwendu F. Okeke^{1, 2}, Chukwudi A. Ogabido^{1, 2}, Hillary I. Obiagwu¹, Chito P. Ilika¹, Obinna K. Nnabuchi¹, Nnaedozie P. Obiegbu¹, Chiemezie M. Agbanu¹, Ebube B. Akosa¹, Stanley C. Egbogu¹, Chinedu L. Olisa¹ and Chukwunonso I. Enechukwu¹

¹Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria

²Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria

³Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Ebonyi State, Nigeria

⁴Department of Psychiatry, Leicestershire Partnership NHS Trust, Leicester, United Kingdom

Cite this paper

Emmanuel C. Egwuatu, Chigozie G. Okafor, George U. Eleje, Osita S. Umeononihu, Chukwuemeka C. Okoro, Jonhnbosco E. Mamah, Tobechi K. Njoku, Charlotte B. Oguejiofor, Chidinma C. Okafor, Chukwunwendu F. Okeke, Chukwudi A. Ogabido, Hillary I. Obiagwu, Chito P. Ilika, Obinna K. Nnabuchi, Nnaedozie P. Obiegbu, Chiemezie M. Agbanu, Ebube B. Akosa, Stanley C. Egbogu, Chinedu L. Olisa and Chukwunonso I. Enechukwu. Ectopic Pregnancies in a Tertiary Hospital in Nigeria: A 10-Year Retrospective Experience. American Journal of Clinical Medicine Research. 2023; 11(2):35-40. doi: 10.12691/AJCMR-11-2-3

Abstract

Background: Maternal morbidity and death have been linked to ectopic pregnancy, particularly in sub-Saharan Africa. Because of early presentation, diagnosis, and treatment, the death rate from it has decreased in high-income countries, but this is not the case in low- and middle-income countries. Given this, it is crucial that we periodically review it in our setting. Objectives: To determine the prevalence, associated risk factors, and treatment modalities of ectopic pregnancy during the study period. Materials and Methods: This is a retrospective cross-sectional study of all cases of ectopic pregnancy at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, between January 1, 2012, and December 31, 2021. The case files of patients who had ectopic pregnancy during the study period were retrieved from the medical records department of the hospital to extract relevant information. A structured proforma was used to collect socio-demographic and clinical data on the subjects. Ethical approval was obtained from the NAUTH Ethics Committee. The data were analysed using Statistical Package for Social Sciences (SPSS) version 25. Results: There were a total of 8194 deliveries, 5892 gynaecological admissions, and 113 ectopic pregnancies. However, only 98 case files of ectopic pregnancies were available with complete information for the study (retrieval rate of 86.7%) and were used for further analysis. This gave a prevalence of 1.38% of total deliveries and 1.92% of gynaecological admissions. The mean age of the patients was 29.07 ± 5.20 years. The average gestational age of the patients at the time of presentation was 7.6 weeks. The most common associated risk factors included previous pelvic inflammatory disease (29.6%), multiple sexual partners (25.5%), and previous termination of pregnancy (23.5%). The treatment modality for all cases in the study was surgical, with total salpingectomy (75.5%) being the most commonly performed surgery. There were 3 (3.1%) maternal deaths due to late presentation and delayed intervention. Conclusion: Ectopic pregnancy remains a major gynaecological problem associated with significant mortality and morbidity. A high prevalence of pelvic inflammatory disease and unsafe abortions result in a high incidence of ectopic pregnancy in our environment. Laparotomy and total salpingectomy also remain the main treatment modality in our environment. Therefore, early diagnosis and timely intervention will go a long way in reducing the morbidity and mortality associated with ectopic pregnancy.

Keywords

ectopic pregnancy, prevalence, risk factors, ruptured ectopic pregnancy, salpingectomy, treatment modalities, treatment outcomes

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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