Afive year retrospective review ofmagnitude and management outcomes of ectopic pregnancy in woliso st.luke hospital, oromia regional state, Ethiopia

Abstract

Background:Globally Ectopic pregnancy (EP) is one of the fatal gynecological emergencies with case fatality rates of 1-3%. Incidence rates of EP in African countries rages between 0.5-2.3 percent of live births. EP in developing countries diagnosis is often late and inadequate; leading to a large number of cases of tubal rupture and hemorrhage accounting case fatality rate is 10 times higher than developed countries. Objectives:The study was conducted to assess the management and factor associated with management outcomes of Ectopic pregnancy in Woliso St. Luke hospital. Methods:A five years Hospital based retrospective descriptive study of EP managed in St. Luke Woliso Hospital, from January 1st, 2009 to December 31st, 2013 was conducted. The medical records of the patients managed for ectopic pregnancy as well as the total birth and gynecological surgery records during the period were retrieved, and data were collected with the aid of data-entry forms designed for this purpose. There were 3,556 gynecological surgery and 14,152 deliveries, with 87 cases of ectopic pregnancies. After data coding, entry and cleaning, analysis was conducted using SPSS 20 software. Data were summarized using Descriptive statistic and logistic regression method was used for variable association. Result: Majority (39.5%) of mothers were in the age group of 25-29 years. proportion of EP among total deliveries and gynecological surgeries was 0.6%&2.3% respectively. Abdominal pain, vaginal bleeding and amenorrhea were the commonest symptoms. PID, previous abortion and cases with low parity were found to have statistically significant association with unfavorable maternal outcomes. Mothers with ruptured EP (76.7%) were from outside Woliso. Conclusions:The 0.6% ectopic pregnancy rate observed in this study must be considered a minimum due to probable underestimation. Unfavorable maternal outcomes were related with prior history of PID, abortions and low parity. Ruptured EP is a true medical emergency which warrants Open abdominal surgery of (salpingooophorectomy) with blood transfusion. Recommendations:Mothers with history of abortion, PID and high parity warrant earlier careful gynecological consultation. High index of suspicion are the key tools to tackle the magnitude of EP before it causes catastrophe.