A Six-Year Review of Ruptured Ectopic Pregnancies at the Olabisi Onabanjo University Teaching Hospital, Sagamu

  • T O Shorunmu
  • M A Lamina
  • P O Adefuye
  • O A Oloyede
  • O L Odusoga
  • A O Olatunji
  • A O Sule-Odu
Keywords: Ectopic pregnancy, Gynaecological emergency, Laparotomy, Maternal mortality, Salpingectomy.

Abstract

Background: Ectopic pregnancy is a major complication of early pregnancy and is a common reason for gynaecological emergency admissions. The ruptured variety accompanied by profuse intra-abdominal haemorrhage is one of the leading causes of maternal mortality in the developing countries.

Objective: To describe the local epidemiology of ruptured ectopic pregnancy at the Olabisi Onabanjo University Teaching Hospital (OOUTH), Sagamu.

Methods: This was a retrospective study of ruptured ectopic pregnancies managed at OOUTH between January 2009 and December 2014. The case records were retrieved from the medical records department. Other relevant information were obtained from the operating theatre registers and pathology department records for statistical analysis.

 Results: Sixty-two cases of ruptured ectopic pregnancies were identified out of 2,875 gynaecological admissions and 2,360 deliveries over the specified period. The incidence of ruptured ectopic pregnancies was 1 in 38 deliveries and prevalence of 2.2% of all gynaecological admissions. About 90.7% of the patients studied belonged to the active reproductive age group (21 – 35 years) while 58.0% were of low parity (Para 0 – 1).

The leading symptoms included abdominal pain (95.2%) and amenorrhoea (83.9%). The fallopian tubes were the sites of implantation in 96.8% of the cases. There were no cases of heterotopic or cervical pregnancy. All the patients had laparotomy and salpingectomy (partial/total) was the commonest procedure undertaken (79.0%). Anaemia was the most frequent postoperative complication (69.4%), and only one death was recorded (case fatality rate of 1.6%).

Conclusion: Ruptured ectopic pregnancy contributed to maternal morbidity and mortality at the study centre. Most of the common predisposing factors in this setting are preventable. 

Author Biographies

T O Shorunmu

Department of Obstetrics and Gynaecology,
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
Telephone: +2348034753464

M A Lamina
Department of Obstetrics and Gynaecology, 
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
P O Adefuye
Department of Obstetrics and Gynaecology, 
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
O A Oloyede
Department of Obstetrics and Gynaecology, 
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
O L Odusoga
Department of Obstetrics and Gynaecology, 
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
A O Olatunji
Department of Obstetrics and Gynaecology, 
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
A O Sule-Odu
Department of Obstetrics and Gynaecology, 
Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.

References

Mascarenhas LJ. Problems in early pregnancy. In: DM Luesley, PN Baker (Eds) Obstetrics and Gynaecology. An Evidence-Based Text for MRCOG. Oxford: Arnold Publications. 2004: 606-615.

Hoover KW, Tao G, Kent CK. Trends in the diagnosis and treatment of ectopic pregnancy in the United States. Obstet Gynaecol 2010; 115(3): 495-502.

Gharoro EP, Igbafe AA. Ectopic Pregnancy Revisited In Benin City, Nigeria: Analysis of 152 Cases. Acta Obstet Gynecol Scand 2002; 81(12): 1139-1143.

Pam IC, Otubu JAM. Pelvic Infections In: Agboola A (Ed). Textbook of Obstetrics and Gynaecology for Medical Students. 2nd edition. Lagos: Heinemann Educational Books. 2006: 61-69.

Abu MH. Ectopic Pregnancy. In: Lawson JB, Harrison KA, Bergstrom S (Eds) Maternity Care in Developing Countries. London: RCOG Press. 2001: 291-301.

UK Health Department. Why Mothers Die. Report on Confidential Enquiries into Maternal Deaths in the United Kingdom 2000-2002. London: Highline Medical Service Organisation. 2004.

Arup KM, Niloptal R, Kakali SK, Pradip KB. Ectopic pregnancy: An analysis of 180 cases. Indian Med Assoc 2007; 105: 308-314.

Aziz S, Al-Wafi B, Swadi HA. Frequency of ectopic pregnancy in a Medical Centre, Kingdom of Saudi Arabia. J Pak Med Assoc 2011; 61(3): 221-224.

Thonneau P, Hijaz Y, Goyaux N, Calvez T, Keita N. Ectopic Pregnancy in Conakry, Guinea. Bull World Health Org 2002; 80: 5(6): 365-370.

Robert L, Nathalie G, Tomohiro M, Patrick T. Ectopic Pregnancy in Africa: A Population-Based Study. Obstet Gynaecol 2004; 103(4): 692-697.

Orji EO, Fasubaa OB, Adeyemi B, Dare FO, Onwudiegwu V, Ogunniyi SO. Mortality and Morbidity associated with misdiagnosis of ectopic pregnancy in a defined Nigerian population, J Obst Gynaecol 2002; 22: 548-550.

Lamina MA, Sule-Odu AO, Olatunji OA, Oloyede OAO. Ectopic Pregnancy in Sagamu, Nigeria: An eight-year review 1990-1997. Afr J Med. Pharm.Sci 2003; 7: 93-101.

Omole-Ohonsi A, Olayinka HT, Attah RA. Ectopic Pregnancy at Aminu Kano Teaching Hospital, Kano, Nigeria. Trop J Obstet Gynaecol 2011; 28(1): 58-63.

Abdul IF. Ectopic pregnancy in Ilorin, a review of 278 cases. Nig J Med 2000; 9(3): 92-96.

Adewunmi AA, Rabiu KA, Tayo AO, Aletan OE. Ectopic pregnancy in Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Nig Med Pract 2010; 58(1-2): 13-16.

Ekele BA. Medical Treatment of ectopic pregnancy using parenteral methotrexate. West Afr J Med 2001; 20:181-183.

Aboyeji AP, Fawole AA, Ijaya MA. Trends in ectopic pregnancy in Ilorin, Nigeria. Niger J Surg Res 2002; 4(1-2): 6-10.

Awojobi OA, Ogunsina S. Ectopic pregnancy in a rural practice. Niger J Med 2001; 10(3): 139-140.

Jogo AA, Swende TZ. Ruptured tubal pregnancy in Makurdi, North Central Nigeria. Niger J Med 2008; 17(1): 75-77.

Barnhart KT, Gosman G, Ashby R, Sammel M. The medical management of ectopic pregnancy: a meta-analysis comparing “single dose” and “multidose” regimens. Obstet Gynaecol 2003; 101: 778-784.

Rajesh V, Mascarenhas L. Evidence-based management of ectopic pregnancy. In: Current Obstetrics and Gynaecology. Elsevier Science Ltd. 2002; 12(4): 191-199.

Jurkovic D. Ectopic Pregnancy in Dewhurst’s Textbook of Obstetrics and Gynaecology. 7th Edition. Edmonds DK. Massachusetts: Blackwell Publishing. 2007:106-116.

Ogedengbe O, Giwa-Osagie OF, Ola R, Fasan A. Contraceptive choice in an urban clinic in Nigeria. J Biosoc Sci 1987; 19: 89-95.

Published
2016-12-20
Section
Articles

Most read articles by the same author(s)