Ectopic pregnancy at a tertiary hospital in North Eastern Nigeria: a 2 year review of the clinical presentations and management

Background: Ectopic pregnancy is a life threatening gynaecological condition associated with adverse reproductive health consequences. It commonly implants in the fallopian tube and most patients in the developing world present  late when it has ruptured leading to maternal morbidity and mortality if intervention is delayed. Method: This was a descriptive cross-sectional retrospective study of patients with ectopic pregnancy managed at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, North east Nigeria between 1st January, 2013 and 31st December, 2014. Data on the age, parity, clinical symptoms and signs and the types of surgical treatment offered was extracted and computed using excel spreadsheet and statistical analysis was done using SPSS (version 23) and results presented as frequency tables, percentages, and mean (± SD). Results: There were 1,577 gynaecological admissions during the period of study and 98 of them (6.2%) were ectopic pregnancies. The total number of deliveries during the same period was 6,738, putting the incidence of ectopic pregnancy to be 1.45% of all deliveries. Majority of the affected patients (39.2%) were between 25- 29 years with a mean and SD of 26.5 ± 4.9 years. Majority of the patients who had ectopic pregnancy 26 (35.1%) were nulliparous women. Of these patients, 97.3% presented with symptoms of abdominal pain, amenorrhoea (83.8%) and vaginal bleeding (68.9%). 97.3% of them had salpingectomy of the affected side. Conclusion: Ectopic pregnancy is a common life-threatening emergency in early pregnancy. Efforts made to improve early diagnosis prior to tubal rupture, would help reduce the associated maternal morbidity and eliminate mortality from this condition

Ruptured Uterus at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria: A 2 Year Review

Background: Rupture of the gravid uterus represents one of the major obstetric emergencies that significantly affect both mother and fetus. It  contributes significantly to the high maternal and perinatal morbidities and mortalities in Sub- Saharan Africa. Method: A retrospective study of pregnant women with ruptured uterus managed at the department of Obstetrics and Gynaecology of Abubakar  Tafawa Balewa University st st Teaching Hospital, Bauchi, Nigeria from 1 January2013 to 31 December 2014. Information on the booking status, age,  parity, place of intrapartum care, aetiology, maternal and perinatal morbidity and mortality, and other relevant information were extracted and  analyzed. Results: The total number of deliveries was 6,738 and those with ruptured uterus were 54, giving a ratio of 1 in 125 deliveries. Prolonged obstructed  labour was the commonest aetiologic factor identified (52.1%). Other factors were grandmultiparity, previous caesarian sections,  trauma, abnormal lie and injudicious use of oxytocin. Twelve of the patients (25.0%) had repair of the ruptured uterus alone, 29(60.4%) had repair  with bilateral tubal ligation. One patient had total abdominal hysterectomy while 6(12.5%) had subtotal hysterectomies. There were a total of 2  maternal deaths with a case fatality rate of 4.2%. Four (8.3%) babies survived. Conclusion: The incidence of ruptured uterus in Bauchi was high in  this study. The identified risk factors included majorly prolonged obstructed labour, the injudious use of oxytocics and also previous caesarean  sections.&nbsp