Ectopic Pregnancy in General Practice: Experience from General Hospital, Calabar, Cross River State, Nigeria

Ectopic pregnancy is associated with increased incidence of morbidity and mortality in women of child bearing age in Nigeria and other developing countries. We sought to determine the incidence, risk factors, clinical presentation and the type of surgical treatment offered in patients who were managed in the General Hospital, Calabar within a 7-year period. Case notes were retrieved from the records department and relevant data extracted for analysis. There were a total of 6,437 deliveries and 1,077 gynaecological admissions. One hundred and thirty (130) ectopic pregnancies were managed giving an overall incidence rate of 2.02% and 12.07% of all obstetrics and gynaecological admissions respectively. The mean age of presentation was 25.23±3.75 years. Majority of the subjects were nulliparous (73.3%). The common clinical presentation was abdominal pain (49.50%). A previous induced abortion (72.7%) was the commonest risk factor identified. Ultrasound was the method commonly employed in diagnosis. Most (67.5%) presented at a gestational age of 7 weeks and below. All study subjects had open laparotomy, mostly salpingo-oophorectomy and salpingectomy. Most of the pregnancies were located on the fallopian tubes at the ampulla (54.7%). Ruptured ectopic accounted for 82.8% of all cases. Post-operatively, anaemia was the common complication noted (7.8%). One (1) patient died giving a mortality rate of 1.3%. With most of the patients presenting late with ruptured ectopic gestation, this therefore, necessitates the need for frontline doctors to be well trained in recognizing and managing ectopic pregnancy, medically and surgically.