Prevalence and management outcome of ectopic pregnancy: a three year retrospective study in adama hospital medical college east shoa zone, oromia region, Ethiopia

Abstract

Background - The prevalence of ectopic pregnancy has increased worldwide with an increase in pelvic infections and improvements in the diagnostic techniques. But the overall prevalence is difficult to determine because of variation in the availability of medical facilities and of course on an individual’s socioeconomic status and attitude towards health, especially in the developing countries. Its frequency is different in various countries and is one of the most critical and life threatening emergencies in gynecological practice that requires immediate treatment. As the gestation enlarges, it creates the potential for organ rupture. So, this study was needed to know the burden of the case, management outcome of ectopic pregnancy and to conclude recommendations based on the findings of the result. Objective: To determine the prevalence and management outcome of ectopic pregnancy patients in Adama Hospital Medical College (AHMC), from January 2010-Dec.30, 2012 G.C Methods: Hospital based cross sectional study design was used from January1, 2010 to December 30, 2012.The period of data collection was March 1-15, 2013GC. The data of sampled patient’s records were collected from medical records. The gynaecological admissions and records of the total pregnancies within the period of study were also used in the analysis. The collected data was checked for any error, coded and entered in to SPSS version 16.0 for data processing and analysis. Descriptive and logistic regression were used and statistically tested at the level of significance of 5%. Results were presented using statements, tables and figures. Finally interpretation, discussion, and recommendations were made based on the findings of this research. Results: 10,801 total pregnancies and 2,867 gynecological admissions were recorded during the three years study period. Records of 158 patients with ectopic pregnancy were retrieved for further analysis making a retrieval rate of 95.8%. 92(58.2%) of the patient was from rural. The mean age of the study participant was 26.54(SD+ 4.89) years. The prevalence of ectopic pregnancy was 1.5% of total pregnancies and 5.5% of Gynecologic admissions. The most common site of implantation was tubal in 156(98.7%) which mostly occurred in the right tube 84(57.1%) and the other site was in the ovary. 9(5.7%) developed post-operative complications. The commonest postoperative complication was paralytic ileus 5(3.2%). About 156(98.7%) patients improved and discharged and 2(1.3%) died postoperatively from complications. Conclusion and Recommendation: Surgery (salpingectomy/salpingo-oophorectomy) was the main stay of treatment. The hospital-based prevalence of ectopic pregnancy per pregnancy has increased over time during the study period. Duration of presentation to hospital, vital sign and amenorrhea duration were found to be predictors of management outcome. The frequency can be reduced by awareness of reproductive health care. Early diagnosis and timely referral may be helpful in treating the patients prior to tubal rupture with decreased morbidity and mortality