February 2022 · Volume 11 · Issue 2 Page 315
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Chukwu JA et al. Int J Reprod Contracept Obstet Gynecol. 2022 Feb;11(2):315-322
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
A decade study of the incidence and clinical analysis of
ectopic pregnancy at a tertiary hospital in Eastern Nigeria
Jemima A. Chukwu
1
*, Ambrose E. Agulanna
1
, Izuchukwu A. Okafor
1,2
,
Agnes A. Nwakanma
3
, Blessing C. O. Osuji
4
INTRODUCTION
EP is a pregnancy in which a fertilized egg gets implanted
in a site other than the endometrium of a woman’s uterus.
It is a life-threatening gynecological emergency, one of the
leading causes of pregnancy-related death in the first
trimester and a major concern to female fertility.
1,2
Following the last three decades, the incidence of EP has
increased nearly to the level of an epidemic disease with
variations from country to country, region to region and
even within the same geographical region.
3,4
Globally, the
incidence of EP ranges from 1.0%-2.0%.
5
A review by
Liskin reported that the highest incidence of EP from the
1960s to the mid-1980s was observed in African countries
DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20220154
1
Department of Anatomy, Nnamdi Azikiwe University, Anambra State, Nigeria
2
Department of Obstetrics and Gynecology, Pan African University of Life and Earth Science Institute (Including Health
and Agriculture), University of Ibadan, Nigeria
3
Department of Anatomy, Chukwuemeka Odumegwu Ojukwu University, Anambra State, Nigeria
4
Department of Medical Services, Nigerian Ports Authority, Delta State, Nigeria
Received: 22 December 2021
Accepted: 12 January 2022
*Correspondence:
Jemima A. Chukwu,
E-mail: ja.chukwu@stu.unizik.edu.ng
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Ectopic pregnancy (EP), a condition where a fertilized egg grows outside a woman’s uterus, is a fertility-
and life-threatening gynecological condition. This study aimed at determining the incidence of EP, clinical presentation,
gestational age at presentation, risk factors and treatment modalities.
Methods: This study was conducted at St. Charles Borromeo specialist hospital, Onitsha, Nigeria (January 2009 to
December 2018). Information were obtained from the hospital’s medical records as retrieved from va rious wards. Data
were analyzed using IBM SPSS, version 23, then presented as percentage in tables and figure.
Results: Out of 13,402 pregnancies recorded in this study, 119 were EPs giving an incidence of 0.89%. 105 case notes
were included in this study since they met the inclusion criteria. Majority of the women belonged to the age group of
26-30 years. Patients with EP presented more between 7-8 weeks of gestational age (40%), though 7.6% were unsure
of their last menstrual period. 80 EP cases (76.2%) were ruptured while 25 (23.8%) were unruptured. The ectopic
gestation occurred most at the ampulla (51.4%) and more at the right side (66.6%) than the left (33.4%). Pelvic
inflammatory disease (30.4%) followed by prior abortion (20.0%) were major predisposing risk factors. The most
common clinical presentations were abdominal pain (92.38%), amenorrhea (57.14%) and vaginal bleeding (51.42%).
85.7% had salpingectomy, 9.5% were medically managed.
Conclusions: EP remains a major gynecological emergency. Diagnosis before rupture could offer an opportunity for a
successful medical management, thereby; minimizing morbidity and mortality.
Keywords: Ectopic pregnancy, Amenorrhea, Salpingectomy, Gestational age