Ectopic Pregnancy in Bauchi, North-East Nigeria

Background: Ectopic pregnancy is an important life-threatening emergency and a cause of reproductive morbidity and mortality especially in developing countries. The significance of ectopic pregnancy in our environment lies in its late presentations with its attendant consequences compounded by structurally weak health systems. This is at variance with the global trend of early diagnosis and conservative approach to thiscondition.Objective: To assess the incidence, presentation and management of ectopic pregnancy (EP), in Bauchi north-east Nigeria over a two-year period.Methods: This was a retrospective study of cases of EP managed at gynaecological unit of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi between 1st of January 2009 and 31st December 2010.Results: During the period under review, a total of 19,412 deliveries were recorded in the hospital and 119 ectopic pregnancies were managed. This gives an incidence of 0.61%. Majority of the patients were 30 yearsand below with mean age of 26.8 years. The common clinical features at presentation were abdominal pain (95%), amenorrhea (87%), vaginal bleeding (51.5%). More than half of the patients were in shock (51.4%)before intervention. Seventy patients (69%) had the EP on the right tube, 10(9.9%) on the left tube while the side was not stated in 20 patients (20.8%). The mode of surgical treatment in majority of the patients wasunilateral salpingectomy 83(82.2%); one patient (1%) had bilateral salpingectomy while the type of surgical operation was not stated in 13 cases (12.9%). None of the patients had minimal access surgery, medical or conservative management. Anaemia (65.3%) was the commonest post-operative complication. Case fatality was 4%.Conclusion: Late presentation of EP was the commonest way of presentation in our centre. Laparotomy with salpingectomy was the main modality of management. This has adverse effect in a society which placeshigh premium on child bearing. Reproductive health education and strengthening support services like blood transfusion services are needed. Provision of minimal access approach facilities and other forms of conservative management for those that present early should be considered.Keywords: Ectopic pregnancy, incidence, presentation and management at a newly established teaching hospital, Nigeri