Diagnostic And Therapeutic Management Of Ectopic Pregnancies

Abstract

Background : Ectopic pregnancy is the most common cause of death among women during the first trimester of pregnancy despite the progress made with early diagnonsis. It occurs at a rate of 1 to 2 % that of live births. In Mauritania, EP is a public health issue mostly effecting young women. Objective : to evaluate the diagnosic abilities and the management of EP. Methods: This study is transverse descriptive and was carried out in the maternity of Nouakchott’s teaching hospital. The aim of this study was to provide data on the epidemiological profile, dignosis, management and prognosis of ectopic pregnancy. During the period from May 2013 to April 2014, 44 cases of ectopic pregnancies were collected. The collected data was analysed by means of SPSS version 20, Microsoft Excel 2007. Result: The incidence of EP was 0.99% coefficient to 1 EP per 100 live births. EP management represented 7.3% emergency surgery. The average patient age was 29.84 ± 5.988 years. The most affected age group was the 25-34 year olds (61.4%). Multigravida were more affected with a rate of 80%. Patients with an EP commonly presented with pelvic pain (91% of our patients), late in menstruation (86.3%) and vaginal bleeding (61.3%). Pelvic ultrasound was performed in 41 patient coefficient to 93%. The treatment was surgical by laparotomy in all of the cases. The surgical treatment was radical in 93.2% : Salpingectomy was performed in 86.4% of the cases, adnexectomy was performed in 6.8% of the cases.Conservative treatment was performed in 3 patients : 2 cases of salpingotomy and 1 case of tubal expression. In most cases, the postoperative evolution was simple. Conclusion: Until this day, ectopic pregnancy is a severe disease. despite the progress made with early diagnonsis in many cases the treatment is surgical with all its consequences and especially in the developing countries including mauritania. Improving the therapeutic management is above all improving the diagnostic procedure in a very early period. And for decades we keep saying that ectopic pregnancy: thinking about it often is not thinking enough.