Igwegbe Ao, Eleje Gu, Okpala Bc
Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, PMB 5025, Nnewi, Anambra State, Nigeria.
Ann Med Health Sci Res. 2013 Apr;3(2):166-70. doi: 10.4103/2141-9248.113655.
Ectopic pregnancy has remained a significant cause of maternal morbidity and mortality especially in the sub Saharan Africa. A periodic appraisal of its management is paramount.
To determine the incidence and associated risk factors, for ectopic pregnancy, review available treatment modalities and suggest interventions to reduce its prevalence, morbidity and mortality.
A cross sectional study with retrolective data collection of all cases of ectopic pregnancy managed in Nnamdi Azikiwe University Teaching Hospital, Nnewi, south-east Nigeria between 1(st) January, 2002 and 31(st) December, 2011 was undertaken. Analysis was carried out using Epi-info 2008 version 3.5.1.
During the study period, there were a total 98 cases of ectopic pregnancies out of 8,811 deliveries and 1884 gynecological admissions, giving an incidence of 0.9% of all attendants or 1 in 90 deliveries and 5.2% of all gynecological admissions. Only 94.9% (93/98) case files were retrieved and were used in the final analysis. The mean age of the patients was 30.1 (0.7) years while the mean gestational age at presentations was 7.4 weeks. Previous induced abortion, 37.5% (36/93) was the commonest associated risk factor, followed by pelvic infections, 35.5% (33/93). The recurrence rate was 6.5% (6/93). Majority, 80.6% (75/93) presented with abdominal pain and 35.8% (33/93) presented with vaginal bleeding. Up to 88.2% (82/93) had salpingectomy while only 2.5% (2/93) were successfully managed medically with methotrexate therapy following diagnosis with transvaginal ultrasound Missed diagnosis of ectopic pregnancy occurred in 16.1% (15/93). There was no maternal death.
Ectopic pregnancy has remained an important gynecological condition in our center. The common identifiable risk factors were induced abortion and pelvic infection. Early first trimester transvaginal ultrasound should be offered to all women for early diagnosis.
异位妊娠一直是孕产妇发病和死亡的重要原因，尤其是在撒哈拉以南非洲地区。定期评估其治疗方法至关重要。
确定异位妊娠的发病率及相关危险因素，回顾现有的治疗方式，并提出降低其患病率、发病率和死亡率的干预措施。
对2002年1月1日至2011年12月31日期间在尼日利亚东南部纽维的纳姆迪·阿齐克韦大学教学医院接受治疗的所有异位妊娠病例进行回顾性数据收集的横断面研究。使用Epi-info 2008 3.5.1版本进行分析。
在研究期间，8811例分娩和1884例妇科住院患者中共有98例异位妊娠病例，占所有就诊者的0.9%，即每90例分娩中有1例，占所有妇科住院患者的5.2%。仅检索到94.9%（93/98）的病例档案并用于最终分析。患者的平均年龄为30.1（0.7）岁，就诊时的平均孕周为7.4周。既往人工流产史占37.5%（36/93），是最常见的相关危险因素，其次是盆腔感染，占35.5%（33/93）。复发率为6.5%（6/93）。大多数患者，80.6%（75/93）表现为腹痛，35.8%（33/93）表现为阴道出血。高达88.2%（82/93）的患者接受了输卵管切除术，而在经阴道超声诊断后，只有2.5%（2/93）的患者成功接受了甲氨蝶呤药物治疗。异位妊娠的漏诊率为16.1%（15/93）。无孕产妇死亡。
异位妊娠在我们中心仍然是一种重要的妇科疾病。常见的可识别危险因素是人工流产和盆腔感染。应向所有女性提供孕早期经阴道超声检查以进行早期诊断。
