Ectopic pregnancy at the Gambian Tertiary hospital

Ectopic pregnancy is a gynaecological emergency with significant burden of maternal mortality and morbidity in the tropics. The incidence reported in the literature range from 1:60 to 1:250 pregnancies. The aim was to determine incidence and risk factors of ectopic pregnancy in the Gambia.

A longitudinal study of ectopic pregnancy at Gambian tertiary hospital from January 2016 to April 2018. Data was collected from patients' folders, entered into SPSS version 20 and analysed with descriptive statistics. The test of variation and significance was by ANOVA and Chi-square respectively with error margin set at 0.05 and confidence interval of 95%.

A total number of 2562 pregnancies were recorded, 43 were ectopic pregnancies. The estimated incidence was 0.2%. Majority of the patients were between 26 - 35 years (56%), primiparous (32%), heterogeneous marriage (82%) and housewives (86%). Occupation was not associated with ruptured or unruptured ectopic pregnancy (p-0.421). Low parity was associated with more ectopic pregnancy than high parity (p-0.001). The commonest clinical feature was abdominal pain (65.1%), whilst the most prominent risk factors were pelvic inflammatory disease (27.9%) and previous abortion (23.3%). Ectopic pregnancy was seasonal.

The incidence rate of 0.2% was in the range reported in the literature. Low parity, previous abortion and pelvic inflammatory disease were the risk factors.