Ectopic pregnancy at the Lagos University Teaching Hospital, Lagos, South-Western Nigeria: Temporal trends, clinical presentation and management outcomes from 2005 to 2014
Ectopic pregnancy at the Lagos University Teaching Hospital, Lagos, South-Western Nigeria: Temporal trends, clinical presentation and management outcomes from 2005 to 2014
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DOI：
10.4103/npmj.npmj_35_20
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发表时间：
2020-07-01
影响因子：
1.1
通讯作者：
Okojie, Osemen
中科院分区：
文献类型：
--
作者：
Olamijulo, Joseph Ayodeji;Okusanya, Babasola Oluwatomi;Okojie, Osemen
背景资料：西南地区异位妊娠发病率的趋势存在不确定性，尽管该地区的生育率低于尼日利亚其他一些地区，避孕药具的使用率较高。研究目的是确定十年来尼日利亚西南部拉各斯的拉各斯大学教学医院（LUTH）异位妊娠的时间趋势、表现和管理结果。受试者和方法：这是一项2005年1月至2014年12月在尼日利亚拉各斯LUTH进行的异位妊娠回顾性研究。参与者的医疗记录用于提取社会人口统计学，临床特征，管理和结果数据。使用Joinpoint回归模型（版本4.7.1）评价趋势，同时使用Stata版本14软件进行描述性统计。结果：异位妊娠434例，总发病率为2.2/100分娩，3.50/100妇科住院。总体而言，异位妊娠率从2005年的1.81/100分娩增加到2014年的2.89/100分娩，增加了59.7%。连接点回归揭示了两个趋势。从2005年到2010年，异位妊娠的发病率最初没有显著下降（年百分比变化[APC] =-1.5%，95%置信区间[CI]：-8.1%至5.6%，P = 0.6）。然而，异位妊娠的发生率从2011年的8.6/100例分娩增加到2014年的25.4/100例分娩，平均每年增加11.6%，具有统计学显著性（APC = 11.6%，95%CI：1.2%至23.1%P < 0.001）。约三分之一（33.9%）的异位妊娠患者的年龄范围为25-29岁，而大多数（68.0%）的患者出现在孕龄9-10周。最常见的可识别的危险因素是既往盆腔感染（35.71%）。输卵管妊娠占96.5%，均行开腹手术。有6名产妇死亡，病死率为1.4%。结论：该院2005 - 2014年异位妊娠发病率有上升趋势。一线卫生工作者需要高度的怀疑指数，以及时诊断和干预育龄妇女异位妊娠。
Background: There is uncertainty in the trend of ectopic pregnancy incidence in the Southwest region, though the region has a lower fertility rate and a higher contraceptive use than some other regions of Nigeria. The study objective was to determine the temporal trends, presentation and management outcome of ectopic pregnancy at the Lagos University Teaching Hospital (LUTH), Lagos, South-Western Nigeria over a decade. Subjects and Methods: This is a retrospective study of ectopic pregnancies at LUTH, Lagos, Nigeria, from January 2005 to December 2014. Participants' medical records were used to extract socio-demographic, clinical characteristics, management and outcome data. Joinpoint regression modelling (version 4.7.1) was used to evaluate the trends while descriptive statistics were conducted using Stata version 14 software. Results: There were 434 cases of ectopic pregnancies giving an overall incidence of 2.2/100 deliveries and 3.50/100 gynaecological admissions. Overall, there was a 59.7% increase in the ectopic pregnancy rate from 1.81/100 deliveries in 2005 to 2.89/100 deliveries in 2014. Join point regression revealed two trends. There was an initial non-significant decrease in incidence of ectopic pregnancy from 2005 to 2010 (annual percent change [APC] = -1.5%, 95% confidence interval [CI]: -8.1% to 5.6%, P = 0.6). However, there was a statistically significant increase in incidence of ectopic pregnancy at an average of 11.6% per annum from 8.6/100 deliveries in 2011 to 25.4/100 deliveries in 2014 (APC = 11.6%, 95% CI: 1.2% to 23.1% P < 0.001). About one-third (33.9%) of the patients with ectopic pregnancy were within the age range 25-29 years while the majority (68.0%) presented at 9-10 weeks of gestational age. The most common identifiable risk factor was previous pelvic infection (35.71%). Majority (96.5%) had tubal pregnancy and all the cases had laparotomy. There were six maternal deaths giving a case fatality rate of 1.4%. Conclusion: The hospital had an increased trend in the incidence of ectopic pregnancy from 2005 to 2014. Frontline health workers need high index of suspicion in the prompt diagnosis and intervention of ectopic pregnancy among women in the reproductive age.