Ectopic Pregnancy in Benue State University Teaching Hospital, Makurdi: A Retrospective Study (2013-2015)

Abstract

Background: Ectopic pregnancy accounts for 9% of all maternal mortality and is the leading cause of maternal death in the first trimester. There are several studies with varying incidence but in our environment, presentation is usually late. Methods: This was a retrospective study of ectopic pregnancies carried out at the Benue State University Teaching Hospital, Makurdi from January 1st 2013 – December 31st 2015. Objective: The study was designed to determine the incidence, clinical pattern, predisposing risk factors, surgical management and morbidity and mortality of patients with ectopic pregnancy. Results: There were nineteen (19) ectopic pregnancies and one thousand one hundred and eleven (1,111) deliveries over the study period giving an incidence of 1.71%. Majority of the patients with ectopic pregnancy were nulliparous (57.9%) in their twenties (47.4%). Previous pelvic inflammatory disease (21.1%) and induced abortion (31.6%) were the predominant risk factors. None of the patients was using any form of contraception. Secondary amenorrhoea, abdominal pain and irregular vaginal bleeding (100%, 94.7% and 42.1%) were the most frequent presenting features. Eighty four percent of the patients had ruptured ectopic pregnancy while 15.8% had unruptured ectopic pregnancy. Of all cases reviewed, 5% of patients presented in shock. Diagnosis was made clinically in 26.3% of cases, while 73.7% were confirmed through ultrasound imaging. All the patients had laparatomy. All the ectopic gestations were tubal (100%). The left tube (52.6%) was more affected than the right tube (47.4%). Sixty eight percent of the patients had blood transfusion and there no maternal death during the surgery. Conclusion: The findings in the study show a high incidence of ectopic pregnancy in this environment and presentation in the hospital was usually late.