Ectopic Pregnancy: A 10 -Year Review of Cases in A Tertiary Health Institution in Umuahia, South East, Nigeria

Abstract

Background: Ectopic pregnancy is a clinical condition where a fertilized ovum implants outside the endometrium of the uterine cavity. Worldwide, ectopic pregnancy complicates 0.25-2.0% of all pregnancies. High index of suspicion of the clinical triad; abdominal pain, amenorrhea and vaginal bleeding is very important for its early detection and management. Objectives: To determine the prevalence, clinical presentations, sites, risk factors and outcomes of ectopic pregnancy in a tertiary health institution in Umuahia, Nigeria. Materials and Methods: This retrospective study was conducted in the Department of Obstetrics and Gynaecology, Federal Medical Centre, Umuahia over a period of 10years from January 2011 to December 2020. The records of patients with ectopic pregnancy were traced through the main theater, ante-natal clinic, and the records unit. All information obtained were coded, entered into and analyzed using IBM SPSS version 25. Results: A total of 268 patients with ectopic pregnancies were studied out of 19,535 gynecological cases and 13,901 deliveries within the study period. This gave a prevalence of 1.4% of all gynecological cases and 1.9% of all deliveries. Ectopic pregnancies occurred more in women between 26 and 35years of age (54.9%). The commonest symptoms seen were abdominal pain (24.7%), Amenorrhea (22.7%) and vaginal bleeding (22.1%). The commonest sites of occurrence were fallopian tube 244 (91.1%), intramural (3.4%) and cervical ectopic pregnancy (2.2%). All the patients were managed surgically while 84% had ruptured uterus. Risk factors observed were a history of PID (30.0%), previous ectopic pregnancy (14.6%), infertility (12.5%), IUCD placement (12.1%) and previous abortion (11.2%). Conclusion: Ectopic pregnancy is one of the leading causes of maternal morbidity and mortality for women of reproductive age. Early diagnosis and management in form of medical treatment or conservative surgery not only reduces maternal morbidity and mortality but also preserves future fertility.

Prevalence and presentation of ectopic pregnancy in a tertiary hospital in Enugu south-east Nigeria: A 10-year retrospective study

“…The age distribution (Table 2) of patients shows that the age group mostly affected is 26-30 years bracket. This is in agreement with some Nigerian studies 10,13,16,21 . This age group represents the peak age of sexual experimentation and motherhood as more women tend to defer childbearing in pursuit of higher education.…”

“…With regards to the total number of gynaecological admissions, the prevalence rate of 3.7% is more than 1.4% reported by Eke et al 16 in Umuahia, but comparable to the 4.1% by Panti et al 13 in Sokoto. It is however less than 4.5% reported by Lawani et al 22 in Abakiliki in 2013, 5.2% and 6.5% respectively reported by Igwegbe et al 10 and Udigwe et al 32 both from Nnewi, and far less than 48.5% reported by Anorlu et al 19 in Lagos.…”

“…Our prevalence rate of 1.1% is clearly less than that reported in some other studies in Nigeria. Musa et al 33 in Jos North-Central Nigeria reported 1.74% in 2009, Awoleke et al 15 in Ekiti South-West Nigeria reported an incidence of 1.8% in 2017, while Eke et al 16 in Umuahia South-East Nigeria reported 1.9% in 2022. This shows progressive rising prevalence of ectopic pregnancy across Nigeria even though the timing and the duration the studies vary and may have affected the results.…”

“…Across Africa, a prevalence rate of 0.5-2.3% of all live births was reported [7][8][9] with most of the studies being institutional hospital-based studies. In Nigeria, the prevalence of ectopic pregnancy is between 1.1-3.8% of all deliveries [10][11][12][13][14][15][16] .…”

Ectopic pregnancies at a tertiary care centre: a five-year retrospective study

“…13 These incidences of ectopic pregnancy are due to various risk factors, such as, pelvic inflammatory disease, infertility, intrauterine contraceptive device, tubal surgeries and assisted reproductive technology, etc. 14 Present retrospective study was done to determine the frequency of its occurrence, clinical features, risk factors, mortality and morbidity associated with ectopic pregnancy in a Tertiary Care Centre.…”