Ectopic pregnancy in Rivers State University Teaching Hospital, Port Harcourt, southern Nigeria: a five- year review

Ectopic pregnancy remains a dire gynaecological emergency associated with increased morbidity and mortality if not diagnosed and managed promptly. The incidence is increasing among women of reproductive age, and of public health importance. To determine the incidence, yearly trend, common risk factors, clinical presentations, mode and outcome of management of ectopic pregnancy in Rivers State University Teaching Hospital (RSUTH). This is a retrospective study of all cases of ectopic pregnancy managed at RSUTH from 1st January, 2015 to 31st December, 2019. Data was analysed using Statistical Package for Social Sciences (SPSS) IBM version 25.0 (Armonk, NY). Over the study period, there were 13,516 deliveries, 8863 gynaecological admissions, and 279 cases of ectopic pregnancy managed. The incidence of ectopic pregnancy in RSUTH is 2.1% (21/1000 deliveries) or 1 in 47 deliveries. Ectopic pregnancy accounts for 3.2% or 32 per 1000 gynaecological admissions.  The mean age of patients was 29.1 SD 5.8 years, (95% CI, 28.5 to 29.8). Majority of the patients 272 (97.5%) and 139 (69.8%) had tubal ectopic pregnancy and tertiary level of education respectively. Tubal pregnancy occurred more on the right tube 176 (63%) compared to left tube 102 (37%). The commonest treatment option was unilateral salpingectomy 276 (98.9%). The mean duration of operation for ectopic pregnancy was 51.3 SD 18.2 minutes, (95% CI, 49.1 to 53.41).   Ectopic pregnancy is common and of increasing trend in our setting. Most of the patients presented late with ruptured ectopic pregnancy and its complications. Improved health seeking behaviour, early diagnosis and prompt treatment would improve clinical outcome.