Ectopic pregnancies in low resource setting: a retrospective review of cases in Kumasi, Ghana

Background: Ectopic pregnancy remains a public health threat for women in reproductive age, and a major cause of maternal mortalities in the first trimester of pregnancy. Past studies in Ghana on the burden of Ectopic Pregnancy (EP) have focused on major referral health facilities with little consideration of primary health facilities. This study was set out to determine the prevalence of Ectopic Pregnancy, demographic characteristics involved and the various types of Ectopic Pregnancy seen in primary health settings in Kumasi, Ghana.Methods: A retrospective descriptive cross-sectional study was conducted at the Suntreso Government and Tafo Government Hospitals in the Kumasi metropolitan area from 2007 to 2017. A review of 28,600 obstetric cases recorded in registers of the two facilities was done using electronic data extraction form. The data were exported into STATA/IC 14.0 for statistical analysis.Results: A prevalence of 0.76% EP was recorded over the study period of 10 years. 61.75% of the women diagnosed with EP were between the ages of 21-30 years with a mean age and standard deviation of 27.61 and 5.91 respectively. Tubal (fallopian tubes) EP was seen in 76.96% of the women diagnosed with EP. 10.18% and 7.19% of the tubal EP occurred in the cornual and fimbriae respectively. Ruptured EP was seen in 58.99% of the cases.Conclusions: The study reported EP in about one in a hundred cases. The commonest EP that emerged from this study was tubal (fallopian tube) EP. Among the tubal EP, cornual and fimbria were the commonest EP that occurred in the fallopian tube. Although cases of tubo-ovarian and ovarian EP are rare, a significant percentage were observed in this study. Early reporting and diagnosis of EP should be of great importance to prevent ruptured EP and any associated complications