Morbidity of ectopic pregnancy at Chris Hani Baragwanath Academic Hospital
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Date
2021
Authors
Mndebele, Sbusiso Trevor
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Abstract
Background: Ectopic pregnancy, is a high-risk condition in which a fertilized ovum implants outside the uterine cavity. The incidence is thought to be higher in developing countries, but specific numbers are not known. The morbidity related to ectopic pregnancy could mostly be avoided if the health service renders better quality care. Objective: This study aimed to describe the demographics and risk factors of patients with ectopic pregnancy, as well as the presentation and condition severity. Furthermore, the purpose of this study was to describe the diagnostic modalities used, and the morbidity and management of ectopic pregnancy in our setting. Methods: The study was a prospective audit carried out in the three gynaecology wards of Chris Hani Baragwanath Academic Hospital. The sample size was 200 admitted ectopic pregnancy patients, counting from the admission book over a 3-month period from August 2018 to October 2018. Demographic data, presenting symptoms and signs, risk factors, diagnostic modality, management, features of the ectopic pregnancy and morbidity were recorded on a Redcap data sheet. Results: Signs of shock were present in 15% of patients and acute abdomen in 85.5% of patients. One hundred and seventy-four (87.0%) patients were diagnosed with ruptured ectopic pregnancies, while 25.0% of patients needed transfusions. One hundred and eighty-six laparotomies and 14 laparoscopies were performed during this study. Conclusion: Most patients presented late with ruptured ectopic pregnancies while some required blood transfusions and intensive monitoring. There is need for comprehensive gynaecological services including contraception and early pregnancy evaluation, in order to improve the morbidity
Description
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology, 2021