Ectopic pregnancy in Ilorin, Nigeria: a four year review

This is to study the incidence, predisposing factors, clinical presentation and management of ectopic pregnancy that presented over a four year period.

This is a retrospective study of 98 ectopic pregnancies managed at the gynaecological unit of University of Ilorin Teaching Hospital, Ilorin from 1st January 2004 to 31st December 2007. Information was obtained from the case notes, theatre and labour ward registers.

A total of 10,054 deliveries were recorded while 1,430 gynaecological patients were admitted. Ninety eight patients had ectopic gestation accounting for 1% of all deliveries and 6.9% of all gynaecological admissions. The peak age group was 25-29 years (33%); 70 (74.5%) were married and 16 (17%) were students mostly undergraduates. Previous pelvic inflammatory disease 78 (83%), previous pelvic surgery 7 (7.4%) and previous history of ectopic pregnancy 2 (2.1%) were the most common risk factors in the patients. Lower abdominal pain 90 (95.7%), missed period 82 (87.2%), dizziness/fainting attack 57( 60.6%) and vaginal bleeding 50 (53.2%) were the predominant symptoms at presentation. There were 2 (2.1%) bilateral ampullary tubal ectopic with one unruptured ec- topic which was treated with linear salpingostomy. Only one (1.1%) case of heterotrophic pregnancy. Open abdominal surgery was the treatment employed in all the patients. No Mortality was recorded.

The incidence of ectopic pregnancy can be reduced by putting in place measures to reduce induced abortion and pelvic inflammatory disease. In addition, early presentation, prompt diagnosis and efficient blood transfusion services will decrease the morbidity and mortality associated with ectopic pregnancy.