IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 16, Issue 11 Ver. XI (Nov. 2017), PP 45-51 www.iosrjournals.org DOI: 10.9790/0853-1611114551 www.iosrjournals.org 45 | Page Ectopic Pregnancy in General Practice: Experience from General Hospital, Calabar, Cross River State, Nigeria * Elvis Mbu Bisong 1 ,Emmanuel Monjok 1,2 , Ita Bassey Okokon 1 , Udeme Essien Asibong 1 ,Vincent Maduka Uhegbu 3 ,Thomas Udagbor Agan 4 , Ekere James Essien 5 1 Department of Family Medicine, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria. 2 Department of Community Medicine, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria. 3 Department of Internal Medicine, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria. 4 Department of Obstetrics and Gynaecology, University of Calabar and University of Calabar Teaching Hospital, Calabar, Nigeria. 5 Institute of Community Health, University of Houston, Texas Medical Center, Houston Texas, USA. Corresponding Author: *Elvis Mbu Bisong1 Abstract: Ectopic pregnancy is associated with increased incidence of morbidity and mortality in women of child bearing age in Nigeria and other developing countries. We sought to determine the incidence, risk factors, clinical presentation and the type of surgical treatment offered in patients who were managed in the General Hospital, Calabar within a 7-year period. Case notes were retrieved from the records department and relevant data extracted for analysis. There were a total of 6,437 deliveries and 1,077 gynaecological admissions. One hundred and thirty (130) ectopic pregnancies were managed giving an overall incidence rate of 2.02% and 12.07% of all obstetrics and gynaecological admissions respectively. The mean age of presentation was 25.23±3.75 years. Majority of the subjects were nulliparous (73.3%). The common clinical presentation was abdominal pain (49.50%). A previous induced abortion (72.7%) was the commonest risk factor identified. Ultrasound was the method commonly employed in diagnosis. Most (67.5%) presented at a gestational age of 7 weeks and below. All study subjects had open laparotomy, mostly salpingo-oophorectomy and salpingectomy. Most of the pregnancies were located on the fallopian tubes at the ampulla (54.7%). Ruptured ectopic accounted for 82.8% of all cases. Post-operatively, anaemia was the common complication noted (7.8%). One (1) patient died giving a mortality rate of 1.3%. With most of the patients presenting late with ruptured ectopic gestation, this therefore, necessitates the need for frontline doctors to be well trained in recognizing and managing ectopic pregnancy, medically and surgically. Key words: ectopic pregnancy, General Practice, Calabar, Nigeria --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 28 -09-2017 Date of acceptance: 28-11-2017 -------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Ectopic pregnancy (EP) remains a significant cause of maternal morbidity and mortality in the first trimester of pregnancy in Nigeria and other developing countries . It is also the commonest gynecological surgical emergency encountered in health care centers in Nigeria and other countries in sub-Saharan Africa (SSA).[1, 2, 3, 4] The commonest clinical presentation in these low income and resource poor countries of SSA is tubal rupture and hemorrhage with its attendant risk of death from hypovolemic shock. [1, 2, 3, 4] The records available from our study site showed that there were 25 maternal deaths during the study period and six of the deaths were due to ruptured ectopic pregnancy, accounting for 24% of maternal deaths. Most district and cottage hospitals which serve a large population of Nigerians in urban, rural and underserved communities are faced with inadequate essential health technologies and a dearth of specialist surgeons, anesthesiologists and gynecologists. Consequently, majority of the surgical procedures in these district hospitals in Nigeria are performed by generalist medical officers. Since the conservative management of EP is not yet being done in these hospitals, as it is now being practiced in the developed countries,[5, 6] a high index of suspicion is required by these frontline doctors to make accurate and prompt diagnosis, in addition to the surgical skills for the management of EP in the districts and peripheral hospitals.