Morbidity and mortality following tubal ectopic pregnancies in Enugu, Nigeria

Summary

Our objective was to determine the current incidence, clinical pattern, surgical and medical management, maternal morbidity and mortality from tubal pregnancies in Enugu, Nigeria. The records of all patients treated for tubal pregnancy at the University of Nigeria Teaching Hospital, Enugu from 1 January 1997 to 31 December 2003 were reviewed. The number of tubal ectopic pregnancies was 136, while the total number of hospital deliveries was 6,003 giving a ratio of 1:44. There were four maternal deaths due to tubal pregnancy, out of a total of 126 maternal deaths that occurred during the same period. Ectopic pregnancy was prevalent in young single women with a previous history of induced abortion and resultant pelvic infection. The most common mode of treatment is salpingectomy. Most gynaecologists are not competent in operative laparoscopy and often do not use medical management of ectopic pregnancy. However, late presentation with haemoperitoneum limits the use of conservative treatment. Maternal morbidity and mortality due to tubal pregnancy is rising in Enugu, Nigeria. Preventive efforts should aim at health education and liberal contraceptive utilisation. Provision of more sophisticated equipment and tests in the management of ectopic pregnancies may in the long term be economically viable. Currently, autotransfusion is under utilised.