Ectopic pregnancy at Usmanu Danfodiyo University Teaching Hospital Sokoto: A ten year review

Background: Ectopic pregnancy continues to be a life threatening gynaecological emergency. Objective: To determine the incidence, pattern of presentation and management of ectopic pregnancy in UDUTH Sokoto. Materials and Methods: This is a retrospective study of cases of ectopic pregnancy managed in the gynaecological unit of UDUTH from 1 st January 2002 to 31 st December 2011. Results: During the period, there was a total of 20,095 deliveries and 7,254 gynaecological admissions in the centre. Two hundred and ninety eight (298) patients had ectopic pregnancy accounting for 1.5% of all deliveries and 4.1% of all gynaecological admissions. Most of the affected patients were young nulliparous women. Abdominal pain, amenorrhoea, vaginal bleeding and cervical excitation tenderness were the most common clinical features amongst patients. The ampulla of the fallopian tube was the commonest site of implantation (59.7%) and majority of the cases (70.1%) were already ruptured at the time of presentation. The main mode of treatment was unilateral salpingectomy (76.3%) However, 3.8% of the patients benefited from medical treatment using methotrexate. The case fatality rate was 1.4%. Conclusion : The rate of ectopic pregnancy in the centre is relatively high. Majority of the patients presented late with the ruptured variety. Improvement in health seeking behaviour among our populace coupled with high index of suspicion and use of modern diagnostic techniques by the clinicians will assist in early diagnosis and treatment prior to tubal rupture which will ultimately lead to reduction in maternal morbidity and mortality associated with the condition.