Kouam L, Kamdom-Moyo J, Doh A S, Ngassa P
Service de Gynécologie-Obstétrique, CHU, Yaoundé, Cameroun.
J Gynecol Obstet Biol Reprod (Paris). 1996;25(8):804-8.
We report in the context of a developing country the results of ectopic pregnancies treated by laparotomy in the last ten years (1984-1993) in the maternity unit of the Teaching Hospital Yaounde (Cameroons). There were 144 cases of ectopic pregnancies from a total of 12,507 deliveries; this corresponds to 11 cases of ectopic pregnancies for 1,000 deliveries. In 75 cases (52%) the patients were operated in emergency situations with clinical signs of ruptured ectopic pregnancy which were later confirmed at laparotomy. In 69 cases (47.9%) the patients were retained in hospital for definitive diagnosis and in the follow-up, the diagnosis was confirmed by laparoscopy in 37 cases (53.6%) and by ultrasonography in 22 cases (31.9%). In this study the frequency of ectopic pregnancy was most common among primiparous women (36 cases) and second parity (37 cases). The highest frequency of ectopic pregnancies was found in women in the age range between 25 and 30 years. Radical treatment of ectopic pregnancy was performed in 62 cases (43.0%) and conservative treatment in 82 cases (56.9%). The main complication during the operation was represented by severe hemorrhage in 65 cases (45.1%); blood transfusion was required in 25 cases. Among the patients who were followed up in the prenatal clinic (98 cases) 16 patients (16.3%) presented an intra-uterine pregnancy and 12 patients (12.2%) a recurrence of ectopic pregnancy. Ectopic pregnancy is a frequent pathology in Cameroon. In the absence of methods for early diagnosis of ectopic pregnancy such as endovaginal ultrasonography and the measurement of beta human chorionic gonadotropin (beta hCG), primary use of laparotomy is necessary when clinical signs of ectopic pregnancy exist. This procedure permits the avoidance of severe complications such as hemorrhage and maternal death. It can be said that laparotomy still has its place in the treatment of ectopic pregnancy in developing countries.
我们报告了喀麦隆雅温得教学医院妇产科在过去十年（1984 - 1993年）对异位妊娠进行剖腹手术治疗的结果。在总共12507例分娩中，有144例异位妊娠；这相当于每1000例分娩中有11例异位妊娠。75例（52%）患者因异位妊娠破裂的临床症状而在紧急情况下接受手术，随后经剖腹手术证实。69例（47.9%）患者住院以明确诊断并进行随访，其中37例（53.6%）经腹腔镜检查确诊，22例（31.9%）经超声检查确诊。在本研究中，异位妊娠在初产妇（36例）和经产妇（37例）中最为常见。异位妊娠发生率最高的是年龄在25至30岁之间的女性。62例（43.0%）进行了异位妊娠的根治性治疗，82例（56.9%）进行了保守治疗。手术期间的主要并发症是65例（45.1%）严重出血；25例需要输血。在产前诊所随访的患者中（98例），16例（16.3%）出现宫内妊娠，12例（12.2%）异位妊娠复发。异位妊娠在喀麦隆是一种常见的病症。在缺乏如经阴道超声检查和β - 人绒毛膜促性腺激素（β - hCG）测定等早期诊断异位妊娠方法的情况下，当存在异位妊娠的临床症状时，剖腹手术仍是必要的。该手术可避免诸如出血和产妇死亡等严重并发症。可以说，在发展中国家，剖腹手术在异位妊娠的治疗中仍有其地位。
