[Management of ectopic pregnancy in developing countries: example of a Nigerian reference maternity]

We report 143 cases of ectopic pregnancy (EP) treated in the Issaka-Gazobi maternity of Niamey between January 1st, 1999 and April 30th, 2001 (28 months). The objective of this study was to estimate the epidemiological, diagnostic and therapeutic aspects to propose actions, which could lead to the improvement of the prognosis of EP.

The frequency of ectopic pregnancy was 2.32% in our study. The patients were young and pregnant for the second or third time. Frequently we observed previous sexually contagious infections and/or abortions. More than 70% of the patients were admitted for a complicated stage of EP.

The culdocentesis allowed to evoke the diagnosis in more than 80% of the cases. It is a simple gesture, which makes it possible to make the diagnosis of EP and which should be taught and practised in maternities of the developing countries. The pelvic ultrasonography and the laparoscopy allowed the diagnosis in the other cases. The tubal localization was the most frequent, cervical and abdominal pregnancies were found. The surgical treatment conducted by laparotomy was conservative in 11.9% and radical in 87.4% of the cases. The mortality rate was still 0.70%.

Prevention of the sexually contagious infections and medical management of abortions are important to reduce the risks of ectopic pregnancies. Education of the patients, living far from the maternity, is also necessary to obtain more precocious consultation in case of pregnancy in order to improve the prognosis of EP.