Ectopic Pregnancy: A Review of Prevalence, Clinical Presentation and Outcome in Gusau, Northwest, Nigeria

Abstract

Background: The prevalence of ectopic pregnancy in Zamfara state is unknown and gynaecological emergency admissions for this condition are on the increase.

Aim: To determine the prevalence, risk factors, clinical presentation and outcome of patients managed for ectopic pregnancy at the Federal Medical Centre Gusau, Zamfara State, Nigeria, from January 2014 to December 2020.

Methodology: This was a retrospective study of ectopic pregnancies at Federal Medical Centre Gusau, Nigeria from January 2014 to December 2020. Participants’ medical records were retrieved to collate socio‑demographic, clinical characteristics, management and outcome information. Data was analysed with SPSS software version 26. Means, frequency and percentages were used to present the significance of the results.

Result: A total of 64 women were managed for ectopic pregnancy between January 1^st 2014 and December 31st 2020 in Federal Medical Centre, Gusau. During this period, there were 20,836 deliveries, giving an incidence of 0.31% (3.1 per thousand deliveries). The Mean age of the patients was 27.4 ± 5.5 years. Amenorrhea, abdominal pain and vaginal bleeding were the most common presentations (100%, 98.4% and 96.9% respectively). The commonest risk factor was a previous history of unsafe abortion in 18/64 (28.1%). The ectopic pregnancy was ruptured in 57 of 64 patients (89.1%), and 5 (8.8%) presented in hypovolaemic shock. Laparotomy was done for all the patients and salpingectomy was performed in 98.4%. Anaemia was the most common complication in 45 of 64 (70.3%) necessitating blood transfusion. There was no case fatality in the study.

Conclusion: The incidence of ectopic pregnancy in our centre was low, the most common risk factor was a previous history of unsafe abortion. The majority of the patients presented late with an already ruptured ectopic pregnancy. Early localisation of pregnancy with the aid of an ultrasound in women with a missed period would identify those with an ectopic pregnancy before it ruptures.