Prevalence, Clinical Profile, and Outcomes of Ectopic Pregnancy at a Teaching Hospital in a Low-Resource Setting, Northern Ethiopia: A 5-Year Retrospective Chart Review.

Abstract

Background: Ectopic pregnancy remains a significant cause of maternal morbidity and mortality worldwide, particularly in low-resource settings. The aim of this study was to investigate the prevalence, clinical profile, and management outcomes of ectopic pregnancies at Ayder Comprehensive Specialized Hospital (ACSH) in Ethiopia between January 1, 2017 and December 31, 2021.

Methods: A cross-sectional study of 152 women diagnosed with ectopic pregnancy and admitted to ACSH between 2017 and 2021 was conducted. Data, including sociodemographic characteristics, obstetric history, clinical presentation, diagnostic methods, intraoperative findings, and management outcomes, were collected retrospectively from medical records. The prevalence of ectopic pregnancy was calculated based on the total number of deliveries during the study period. Descriptive statistics were used to summarize the data.

Results: Of 23,090 deliveries in the ACSH between 2017 and 2021, 152 cases of ectopic pregnancy were registered, corresponding to a prevalence of 6.58 per 1000 deliveries. The average age of the women was 28 years (SD ± 0.5), with the majority (55.5%) between 25 and 34 years old. Most patients (78.3%) lived in rural areas. Multigravida women accounted for 58.6% of cases. There was a history of abortion in 28.3% of women and a history of previous ectopic pregnancy in 6.6%. The most common clinical findings were tender abdomen (84%), adnexal motion tenderness (53%), and cervical motion tenderness (45%). Hemoglobin levels below 11 mg/dL were observed in 41% of cases. The majority of ectopic pregnancies were diagnosed using both clinical assessment and ultrasound (88.8%). Surgical management was the primary treatment modality (92.1%), with salpingectomy performed in 92.8% of cases. Blood transfusions were required in 29.6% of patients. The median length of hospitalization was 3 days (IQR = 2).

Conclusions: With a prevalence of 6.58 per 1000 deliveries, ectopic pregnancy remains a major health problem in ACSH. Most patients presented with acute symptoms requiring surgical intervention. Early detection and improved access to reproductive health services could reduce the morbidity of ectopic pregnancy in the region.