Incidence, risk factors, clinical presentation and treatment of ectopic pregnancy in the Limbe and Buea Regional Hospitals in Cameroon
| Autor: | Claude Ngwayu Nkfusai, John Palle Ngunde, Samuel Nambile Cumber, Meh Martin Geh, Mandeng Ma Linwa Edgar, Atabong Emmanuel Njingu, Gregory Edie Halle-Ekane |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Pregnancy Ectopic pregnancy treatment business.industry Obstetrics medicine.medical_treatment Incidence (epidemiology) lcsh:R clinical presentation lcsh:Medicine Abortion medicine.disease Laparotomy Salpingectomy Pelvic inflammatory disease Nested case-control study medicine ectopic pregnancy risk factors business |
| Zdroj: | PAMJ Clinical Medicine, Vol 2, Iss 95 (2020) |
| ISSN: | 2707-2797 |
| Popis: | Introduction: ectopic pregnancy (EP) is the leading cause of maternal mortality in the first trimester of pregnancy in our environment. This study aimed at evaluating the incidence, risk factors, clinical presentation and treatment of ectopic pregnancy in the Limbe and Buea Regional Hospitals in Cameroon. Methods: this was a retrospective nested case control study carried out from December 2006 to December 2016. A ratio for control vs cases of 3:1 was obtained. Any pregnancy implanted outside the normal uterine cavity was considered as an ectopic pregnancy. Student's t-test was used to compare continuous variables and Pearson's Chi-square test for categorical variables. The association between EP and the demographical and clinical variables was estimated using logistic regression. Statistical significance was set at p-values less than 0.05. Results: a total of 247 cases of EP were registered out of 17221 deliveries giving an incidence of 1.43% in ten years. History of pelvic inflammatory disease (OR = 3.10, CI (1.76-5.44), p less than 0.001), previous EP (OR = 10.22, CI (2.61-14.82), p less than 0.001), History of induced abortion (OR = 2.68, CI (3.32-9.73), p less than 0.001), history of adnexa surgery (OR = 4.37, CI (2.17-10.32), p less than 0.001) and history of appendectomy (OR = 2.16, CI (0.99-6.64) p less than 0.001), were also found to be associated with increased risk of EP. More than five percent (5.52%) of the patients were in shock at presentation. Diagnosis was confirmed mainly by use of ultrasound (78.53%) and treatment was principally by laparotomy (97.55%) with salpingectomy (95.60%). Most (90.18%) of ectopic pregnancies were ruptured at presentation. Only 2.45% of cases were manage medically with the use of methotrexate. Conclusion: the incidence of ectopic pregnancy (EP) in our environment is within the global range (hospital-based incidence of 1.43%) and is rising. Late presentation, lack of modern diagnostic and management tools have made laparotomy with salpingectomy the principal method of management of ectopic pregnancy in our environment. |
| Databáze: | OpenAIRE |
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