Abstract:
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<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 <
0.001), previous EP (OR = 10.22, CI (2.61-14.82), p < 0.001), History of induced abortion (OR = 2.68, CI (3.32-9.73), p< 0.001), history of adnexa surgery
(OR = 4.37, CI (2.17-10.32), p < 0.001) and history of appendectomy (OR = 2.16, CI (0.99-6.64) p< 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.
