Clinical Presentation and Management of Ectopic Pregnancy: A 10-Year Review at a Federal Teaching Hospital in North-Western Nigeria

Abstract

Background: Ectopic pregnancy is a major cause of first trimester pregnancy loss and an important cause of maternal morbidity and mortality in developing countries where majority of the patients present late with ruptured variant. Objectives: To determine the prevalence, clinical presentation and management of ectopic pregnancy at the Federal Teaching Hospital Katsina (FTHK). Methodology: A retrospective study of ectopic pregnancies managed at the FTHK between January 1st, 2010 and December 31st, 2019. Data were extracted from the patients’ case notes, collated and analysed using SPSS. Result: A total of 20,089 patients were managed for pregnancy related conditions and 182 cases were ectopic pregnancies putting the prevalence of ectopic gestation at 9/1,000 pregnancies. The mean age of the patients was 26.7±6.9 years and the highest frequency of ectopic pregnancy was seen in women between 21-25 years of age. The commonest presenting symptom was abdominal pain (95.3%). Most patients presented with ruptured ectopic pregnancy while 15.1% presented in shock. The commonest risk factor was pelvic inflammatory disease (PID). Fallopian tube (94.5%) was the main location of ectopic pregnancy and 92% of the patients had unilateral salpingectomy. There was 0.6% case fatality. Conclusion: The prevalence of ectopic pregnancy was relatively stable with high rate of ruptured ectopic pregnancy and radical tubal surgery.