Ectopic Pregnancy: Lagos University Teaching Hospital Experience Over A Five-Year Period

Ectopic pregnancy remains one of the commonest gynaecological emergencies in developing countries. In a retrospective study of ectopic pregnancy carried out at Lagos University Teaching Hospital (LUTH), Lagos, Nigeria, over a five year period, 272 cases were managed with an incidence of 43.8/1000 deliveries. 85.7% of the 196 patients evaluated were found to be in the active reproductive age group (20 - 34 years) and 65% were of low parity (para 0-1). Previous abortions, pelvic inflammatory disease and pelvic adhesions were the common associated risk factors. 99% of the patients presented in the ruptured state. Accurate diagnosis was made in 89% of the patients within 24 hours of presentation. Misdiagnosis occurred in only 11% of the patients and correct diagnosis was made later with laparoscopy and/or ultrasonography. Abdominal pain or tenderness, pallor and amenorrhoea constituted the commonest clinical features. Paracentesis abdominis and/or culdocentesis gave positive result in 83% of our patients and no false positive result was recorded. Immediate Laparotomy with total salpingectomy or segmental partial salpingectomy was the commonest surgical procedure. Only 2.7% of the patients had conservative surgery. Anaemia was the commonest post operative complication (77%). Ten deaths occurred giving a case fatality rate of 3.7%. An intensive health education programme towards reducing the risk factors and avoidance of delay in diagnosis/management were suggested as means of reducing the associated morbidity and mortality in ectopic pregnancy. Nigerian Quarterly Journal of Hospital Medicine Vol. 9, No. 2 (June 1999) pp. 100-10