Ectopic Pregnancy in an Urban Tertiary Centre in Southern Nigeria: Emerging Trends
Keywords:ectopic pregnancy, rupture, conservative management, methotrexate
Introduction: Ectopic pregnancy is an important cause of morbidity and mortality in early pregnancy. Its’ incidence is rising and management has shifted to less radical and conservative methods with less complications. In resource limited countries like Nigeria, it is pertinent to review management options available in a tertiary referral centre.
Methodology: All cases of ectopic pregnancies managed at University of Benin Teaching Hospital (UBTH) Nigeria between 1st January 2003 and 31st December 2007 were retrospectively reviewed. Socio-demographic and clinical data were retrieved from case files, operating notes, theater and ward registers for analysis.
Results: There were 242 cases of ectopic pregnancies, and 7848 total deliveries during the period reviewed thus giving an ectopic pregnancy incidence of 3.1% (1 in 32 deliveries). Most of the patients (50.9%)werenulliparous. Themajoridentifiedpredisposingfactorswerepreviousabortion(64.5%)and history of pelvic inflammatory disease (37.7%). Majority of the patients (98.7%) had laparotomy while 2.6% had conservative medical management with methotrexate. Ruptured tubal pregnancy (95.6%) was themostcommontypeofectopicgestation. Therewasonematernaldeath,givingacasefatalityrateof 0.4%.
Conclusion: The incidence of ectopic pregnancy in the centre is rising compared to previous report from the institution. Although there is an increasing trend towards provision of conservative management in developing countries, the benefits are largely unharnessed because most patient still present late. This should stimulate aggressive promotion of the benefits of early presentation which include less invasive treatment options.
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