Abstract:

Background: Ectopic pregnancy is one of the causes of maternal mortality and morbidity in the first trimester. It is estimated that worldwide around 10-15% of maternal deaths in first trimester are contributed by ectopic pregnancy, the aim of this study was determine clinical presentation and factors associated with long hospital stay among the suspects of ectopic pregnancy in our setting.

Method: A cross sectional was conducted between September 2012 and April 2013 at BMC involving patients in first trimester pregnancy with features suspected to have ectopic pregnancy. All patients were recruited as they came in; no specific sampling technique was used. Data were collected using a data collection tool and analyzed using STATA version 11.

Results: A total of 93 patients were recruited in the study. Among 93 patients 86 (92.4%) had ectopic pregnancy that was confirmed by histopathology results and seven patients had other gynecological and non-gynecological lessions. Amenorrhea and lower abdominal pain were the most clinical presentation (98.9% and 100% respectively) 82.8% patient had gestation age less than 13 weeks. Most participants presented with more than one symptom. Amenorrhea, lower abdominal pain and positive urine pregnancy test had the highest sensitivity and positive predictive values. Shock presented in 36 (38.7%) patients. The mean days of the hospital stay was four days. Long hospital stay was associated with severe anemia hemoglobin level less than 7g/dl. (P-value 0,004), need of blood transfusion more than two units, (P-Value 0.007), parity (P-value 0.004) and abdominal pregnancy (P-value 0.049).

Conclusion and Recommendations: Results from this study show that the most clinical presentation of ectopic pregnancy was amenorrhea, lower abdominal pain, and shock 76.8% of patients have ruptured ectopic pregnancy at the time of diagnosis that contributed to other morbidities and prolongation of hospital stay. Hence there is a need to improve diagnostic criteria by having accurate diagnostic tools that will allow delivering a timely management with wide range of options including the conservative approach.