Musa J, Daru P H, Mutihir J T, Ujah I A O
Department of Obstetrics and Gynaecology, Jos University Teaching Hospital, Jos.
Niger J Med. 2009 Jan-Mar;18(1):35-8.
Ectopic pregnancy remains a major gynaecological problem in contemporary gynaecological practice. Not only do women die from this disease, but also of greater clinical importance is the indirect morbidity of poor fertility prognosis and adverse outcome in subsequent pregnancies. We were interested in documenting the prevalence of ectopic pregnancy and its impact on subsequent fertility.
This retrospective descriptive study was done at the Jos University Teaching Hospital. The case notes of all patients who had tubal ectopic pregnancy managed in JUTH between January 1997 and December 2000 were retrieved. Subsequent fertility and reproductive outcome were assessed among women who reported back for follow up fora minimum period of twelve months post surgery. The data was analyzed using frequencies.
During the study period, January 1997 and December 2000 a total of 168 ectopic pregnancies were managed and 9,638 deliveries occurred during the same period. This gives a prevalence rate of 1.74%. Of the 168 cases of ectopics, 130 case records containing relevant information were retrieved (77.4%) and this constituted the sample population for the study. Majority (53.8%) of the women were between 20 and 29 years. Majority of the women were either nulliparous or primiparous (23.8% and 20.0% respectively). Tubal rupture occurred in 86.9% of the women at the time of laparotomy. Total salpingectomy was the surgical modality in 77.7% of the cases. The right fallopian tube was affected in 66.2% and the left 33.8% of the cases. The contralateral fallopian tube was grossly normal in 73.1% of cases. Of the 64 women who were followed up for a minimum of 12 months, 40.6% achieved viable intra uterine pregnancies, 6.3% had a repeat ectopic pregnancy in the contra lateral tube and 53.1% were unable to achieve pregnancy.
Ectopic pregnancy is prevalent in our environment affecting mainly young women of low parity who desire future pregnancies. The subsequent impact on future fertility of these women could be improved if efforts are focused on early diagnosis to prevent tubal rupture. Early diagnosis prior to rupture offers opportunity for medical management and conservative surgical procedures that are proven to improve future fertility prognosis.
在当代妇科实践中，异位妊娠仍然是一个主要的妇科问题。女性不仅会死于这种疾病，更重要的是其间接发病率对生育预后不良以及后续妊娠的不良结局有着重大影响。我们有兴趣记录异位妊娠的患病率及其对后续生育能力的影响。
这项回顾性描述性研究在乔斯大学教学医院进行。检索了1997年1月至2000年12月期间在JUTH接受输卵管异位妊娠治疗的所有患者的病历。对术后至少随访12个月的女性的后续生育能力和生殖结局进行了评估。数据采用频率进行分析。
在研究期间，即1997年1月至2000年12月，共处理了168例异位妊娠，同期有9638例分娩。患病率为1.74%。在168例异位妊娠病例中，检索到130份包含相关信息的病例记录（77.4%），这构成了研究的样本群体。大多数（53.8%）女性年龄在20至29岁之间。大多数女性为未产妇或初产妇（分别为23.8%和20.0%）。86.9%的女性在剖腹手术时发生输卵管破裂。77.7%的病例采用了全输卵管切除术。66.2%的病例右侧输卵管受累，33.8%的病例左侧输卵管受累。73.1%的病例对侧输卵管大体正常。在64名至少随访12个月的女性中，40.6%实现了宫内活胎妊娠，6.3%在对侧输卵管再次发生异位妊娠，53.1%未能实现妊娠。
异位妊娠在我们的环境中很普遍，主要影响低生育次数且渴望未来怀孕的年轻女性。如果将重点放在早期诊断以预防输卵管破裂上，这些女性对未来生育能力的后续影响可能会得到改善。破裂前的早期诊断为药物治疗和保守性手术提供了机会，这些方法已被证明可以改善未来的生育预后。
