Ectopic Pregnancy: A 10 Year Review in a Tertiary Hospital in South-South, Nigeria

Abstract

Background: Ectopic pregnancy continues to be a life threatening gynaecological emergency. In the past decade morbidity and mortality has decreased dramatically but the incidence is rising worldwide. Objective: To determine the incidence, pattern of presentation, diagnosis and management of ectopic pregnancy at the Federal Medical Centre, Yenagoa, Bayelsa state, Nigeria. Materials and Methods: This is a retrospective descriptive study of cases of ectopic pregnancy managed from 1st of January 2008 to 31st of December 2017. Results: During the period, a total of 12,000 deliveries were recorded. 300 patients had ectopic gestation accounting for 2.5% of all deliveries. The mean age was 27.78 +/- 5.2 years.  The presenting complaints varied extremely with abdominal pain (97.7%) being the most frequent. A large proportion of patients (50.3%) presented with past history of induced abortion. Diagnosis was made solely on clinical findings in 49% of cases. Surgical management was the most frequent method of management (99.3%). Only 2 patients (0.7%) benefited from methotrexate therapy.  Approximately 79% had blood transfusion. There were 10 maternal deaths giving a case fatality rate of 3.3%. Conclusion: Ectopic pregnancy is still a major health problem amongst women of reproductive age presenting to the gynaecology unit of the Federal Medical Centre, Yenagoa. Majority of patients present late, making tubal conservative treatment inappropriate. Case fatality rate in this study shows that ectopic pregnancy is still a significant cause of maternal mortality in our environment.