Diagnosis of Unruptured Ectopic Pregnancy is Still Uncommon in Ghana

Abstract

Summary objectives: To find out why the detection of ectopic pregnancy before its rupture continues to be low at the Korle Bu Teaching Hospital and to suggest ways of improving upon the detection rates.

Design: Longitudinal retrospective descriptive survey.

Setting: Gynaecology unit of Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital.

Subjects and methods: Interview, between the 3(rd) and 5(th) post-operative days, of 1492 patients who had operative diagnosis of tubal pregnancy was conducted for socio-demographic data, circumstances of admission with ectopic pregnancy and desire to have more children. The case notes were also reviewed for operative findings.

Results: The incidence of tubal ectopic pregnancy was 32.90 per 1000 deliveries and unruptured cases formed 5.43%. Lack of awareness of early pregnancy, late reporting by women to health care facilities when aware of pregnancy and failure of health care providers to utilize the diagnostic aids for detecting unruptured ectopic pregnancy (like serum beta human chorionic gonadotrophin and ultrasonography) were the main reasons for the low detection rates.

Conclusions: Health education to encourage women to attend clinic early in pregnancy, especially when experiencing unusual symptoms of lower abdominal pain and irregular vaginal bleeding could help in the diagnosis of unruptured ectopic pregnancy. Judicious use of diagnostic aids for detecting unruptured ectopic pregnancy by health care providers should improve upon the detection rates.