Prevalence of ectopic pregnancy in surgical patients at a tertiary hospital in Rivers State, Nigeria

S, Eli; G, Owhonda; KE, None Okagua; Iwo-Amah,; U, None Ocheche; EI, Nonye-Enydah; IE, None Wakama; NM, None Inimgba

doi:10.30574/wjarr.2023.17.2.0038

Cited by 1 publication

(7 citation statements)

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“…[1][2][3][4] Majority of patients will present with a ruptured sac although this is changing with increasing availability and expertise in sonography. [1][2][3][9][10][11][12] An alternative to reduce hospital stay (with less family disruption), reduce cost as well as eliminate surgical and anaesthetic risks in medical management which is applicable only to unruptured ectopic gestation like our patients presentation. [2][3][4][5] Medical management for ectopic pregnancy has been carried out with various agents including Methotrexate, Actinomycin D, hypertonic saline and potassium chloride with different success rates.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7][8] Methotraxate is commonly used because it is inexpensive, less invasive and can be administered on outpatient basis. [9][10] Methotraxate is administered either as a single dose regimen capped at 100mg or as a multi-dose regimen as was done in our case. The multidose regimen is preferable in obese patients like ours.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] There are recommended criteria to be met for the usage of methotrexate in the management of ectopic pregnancy. [1,3,[8][9][10]These include a clinically stable patient with unruptured ectopic pregnancy, haemodynamically stable and well motivated patients. [1][2][3] Our patient met these criteria.…”

Section: Discussionmentioning

confidence: 99%

“…[1,5] Management options are surgical, medical and expectant management. [1,9] The main stay of treatment in our environment and most developing nations is the surgical management typically the open salpingectomy with its attendant disadvantages including anaesthetic and surgical risks as well as family disruption from prolonged hospital stay and income loses. [2][3][4][9][10] Laparoscopic salgingectomy reduces morbidity and hospital stay but the skill and facilities for it are not readily available and its high cost were available puts it out of reach of the average patient.…”

Section: Introductionmentioning

confidence: 99%

“…[1,9] The main stay of treatment in our environment and most developing nations is the surgical management typically the open salpingectomy with its attendant disadvantages including anaesthetic and surgical risks as well as family disruption from prolonged hospital stay and income loses. [2][3][4][9][10] Laparoscopic salgingectomy reduces morbidity and hospital stay but the skill and facilities for it are not readily available and its high cost were available puts it out of reach of the average patient. [1][2][3][4] Medical management also known as the non-surgical approach is not widely practiced in our environment despite its several advantages over the traditional open salpingectomy including its less invasiveness, reduced cost and absence of anaesthetic risk, surgical risk and need for hospital admission.…”

Section: Introductionmentioning

confidence: 99%

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Medical management/Non-surgical of ectopic pregnancy: Case report and review of literature

Okagua KE,

Eli S,

Adewale O

et al. 2023

World J. Adv. Res. Rev.

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Ectopic pregnancy is a cause of maternal morbidity and mortality. Management options are surgical, medical and expectant management. Medical management also known as the non-surgical approach is not widely practiced in our environment despite its several advantages over the traditional open salpingectomy including its less invasiveness, reduced cost and absence of anaesthetic risk, surgical risk and need for hospital admission. It however requires early presentation and diagnosis before tubal rupture, a well motivated patient and fulfilment of strict criteria in well selected patients. Aim. To present this rare case report of the medical/non-surgical management of unruptured ectopic pregnancy and a review of the literature. Case report: Mrs AW, Para 3+0 (2 alive) who presented with lower abdominal pains and abnormal scanty vaginal bleeding following 6 weeks of amenorrhoea. Her physical examination revealed a stable cardiovascular state. There were no significant abdominal findings. Vaginal examination revealed positive cervical motion tenderness. A diagnosis unruptured ectopic pregnancy was made. Pelvic ultrasound scan revealed a cystic left adnexial mass measuring 1.94 cm by 1.7 cm with thickened, well circumscribed margins and it contained an echogenic mass (fetal pole) with cardiac pulsation (145/min). The crown-rump length was 0.76cm which corresponded to 6 weeks plus 5 days of gestation. Her serum β hCG was 3625.8miu/ml. She expressed her aversion for a surgical intervention having had 3 previous surgeries. She gave an informed consent for medical/non-surgical management with intramuscular Methotrexate. She subsequently received 3 doses of weekly 100mg intramuscular methotrexate. Each dose of Methotrexate was preceded by re-evaluation of liver/renal function test, full blood count and serum β hCG. By the 4th week of treatment the success of her treatment was confirmed by the insignificant level of β hCG and findings at TVS. She was counselled on the need for prompt localization of any subsequent pregnancy. Conclusion: We presented Mrs AW who was successfully managed for unruptured ectopic pregnancy using the medical/non-surgical approach on out-patient basis. Proper patient selection and follow-up is required for a favourable outcome,

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