Cross sectional comparative study between women admitted for ruptured ectopic pregnancy and those who presented at the antenatal booking clinic at a secondary hospital in southwest Nigeria

Background: Ectopic pregnancy is a major gynaecological emergency; it is a major contributor to the high maternal mortality in Nigeria. Most patients in developing countries often present with rupture due to delay in seeking medical intervention. With ruptured ectopic pregnancy, treatment is salpingectomy leading to reduced fertility. In most parts of the world, especially, in developing countries the incidence of ectopic pregnancy has increased in the last three decadesObjective: To compare the socio-demographic, sexual and reproductive factors among patients managed for ectopic pregnancy and pregnant women attending the ante-natal care in a secondary care centre.Method: In this comparative study, 102 patients who presented with ruptured ectopic pregnancy over a period of twelve months to the State Specialist Hospital, Akure were compared with 100 randomly selected pregnant women in the second trimester (control) from the booking clinic of the same hospital.Results: There were 2376 live births and 1058 gynaecological ward admissions during the period out of which 102 were ectopic pregnancies. The incidence of ruptured ectopic pregnancy in this study was 4.3% or 4293 per 100,000 live births and it accounted for 9.6% of all gynaecological admissions. Patients in both arms were similar in age, marital status and parity but different in socio-economic status. More women in the control group belonged to the high socio-economic class. The odds ratio of developing ectopic pregnancywas highest for history of previous use of IUCD (7.7955 95% CI 1.7233 to 35.2640) and lowest for previous pelvic surgery (0.4160 95% CI 0.2159 to 0.8016).Conclusion: Ectopic pregnancy has a high incidence in developing countries and is a major indication for admission to the gynaecological ward. Major risk factor for ectopic pregnancy in this study was previous use of IUCD OR 7.7955 95% CI 1.72 to 35.26Keywords: Ruptured ectopic pregnancy, booked patients, risk factors, odd ratio