Ectopic Pregnancy in Tigray, Ethiopia: A Cross-Sectional Survey of Prevalence, Management Outcomes, and Associated Factors.

Autor: Berhe ET; Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia., Kiros K; School of Medicine, College of Medicine and Health Science, Aksum University, Aksum, Ethiopia., Hagos MG; Department of Midwifery, College of Health Sciences, Aksum University, Aksum, Ethiopia., Gesesew HA; Discipline of Public Health, Flinders University, Adelaide, Australia.; Department of Epidemiology, College of Health Sciences, Mekele University, Mekele, Ethiopia., Ward PR; Department of Epidemiology, College of Health Sciences, Mekele University, Mekele, Ethiopia., Gebremeskel TG; Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.
Jazyk: angličtina
Zdroj: Journal of pregnancy [J Pregnancy] 2021 Nov 30; Vol. 2021, pp. 4443117. Date of Electronic Publication: 2021 Nov 30 (Print Publication: 2021).
DOI: 10.1155/2021/4443117
Abstrakt: Background: Ectopic pregnancy is a neglected and challenging gynecologic problem in developing countries including Ethiopia.
Objective: The present study is aimed at assessing the prevalence of ectopic pregnancy, its management outcomes, and factors associated with management outcomes in Tigray, North Ethiopia.
Methods: We employed a four-year retrospective cross-sectional study from September 2015 to August 2019. We extracted data about all pregnant mothers who were admitted and managed for EPs in Axum, Tigray. Ectopic pregnancy and its outcomes (favorable and unfavorable) were the dependent variables, and age, residence, ethnicity, religion, parity, history of abortion, history of EP, pelvic infections, history of surgical procedures, and use contraceptives were the independent variables. We employed descriptive statistics and bivariate and multivariate logistic regression analyses using SPSS. Ethical clearance was obtained from Axum University, Tigray, Ethiopia.
Results: The overall prevalence of ectopic pregnancy was 0.52% of total deliveries, which equates to 1 : 193 deliveries. Surgery for ectopic pregnancy accounts for 7.6% of all gynecological surgeries. Most participants were in the age group 26-30 years and lived in rural areas. Among the different EP implantation sites, most cases (92.4%) occurred in the fallopian tube, followed by 5.1% in the ovary and 2.5% in abdominal EPs. Surgical management (laparotomy) was undertaken for all the 79 women diagnosed with EPs, including laparotomy (100%), salpingo-oophorectomy (17.7%), salpingectomy (73.9%), oophorectomy (3.4%), cornual resection (2.5%), and removal of concepts tissue 2.5. The record reports that intraoperative procedure was correctly managed for 47 (59.5%) women but the condition of EP procedure was ruptured for about two-thirds (63.3%) of the women. Thirty (38%) patients had developed some complications after surgery including anemia (hemoglobin < 10.5) ( n = 12), fever ( n = 10), wound infection ( n = 2), and pneumonia ( n = 2). Women who were from urban (AOR = 11.2, 95% CI: 2.65-47.2) and who had normal hemoglobin at presentation (AOR = 9.94, 95% CI: 2.03-48.7) were associated with favorable maternal outcomes.
Conclusions: More than one-third of women with ectopic pregnancies had an unfavorable maternal outcome, which was higher among rural residents and anemic mothers. Women living in rural areas and anemia during pregnancy should seek special attention in the management of EPs. We also recommend improving the data management of hospitals in Ethiopia.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2021 Elsa Tesfa Berhe et al.)
Databáze: MEDLINE
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