Clinical anatomical patterns and associated early management outcomes of ectopic pregnancy among pregnant women at Iringa regional referral hospital

Murihano, Richard Niyo

dc.creator	Murihano, Richard Niyo
dc.date	2022-03-03T12:16:27Z
dc.date	2022-03-03T12:16:27Z
dc.date	2021
dc.date.accessioned	2022-10-20T14:03:24Z
dc.date.available	2022-10-20T14:03:24Z
dc.identifier	Murihano, R. N. (2021). Clinical anatomical patterns and associated early management outcomes of ectopic pregnancy among pregnant women at Iringa regional referral hospital (Master's dissertation). The University of Dodoma, Dodoma.
dc.identifier	http://hdl.handle.net/20.500.12661/3419
dc.identifier.uri	http://hdl.handle.net/20.500.12661/3419
dc.description	Dissertation (MMED Obstetrics and Gynecology)
dc.description	Ectopic pregnancy is a life threatening clinical condition which when not diagnosed and promptly managed early leads to maternal morbidity and mortality. Currently the exact prevalence, clinical anatomical patterns and associated early management outcomes in our setting is not well documented and also an associated morbidities put unknown resource burden to facilities during management of women with ectopic pregnancy at Iringa regional referral hospital in Tanzania. This study therefore is aimed at determining clinical anatomical patterns and associated management outcomes. This was a prospective cross sectional study carried at Iringa Regional Referral Hospital from June to December 2020. Ectopic pregnancy was diagnosed based on history taking, physical examinations urinary pregnancy test, ultrasonography and incidental ectopic pregnancy findings at laparotomy. All findings at laparotomy, surgical procedures performed, postoperative early managements outcomes were all entered in the questionnaire and all patients were followed up till discharge. Filled questionnaires were entered in statistical program and were analyzed by using a IBM SPSS version 25. Results were summarized into frequencies and percentages while numerical variables were summarized into means, median and standard deviations. In this study there were 105 confirmed women with EP of which 75(71.4%) were tubal and 30(28.6%) were non tubal. The participants age was between 20 years to 46 years with mean age of 29.7years (SD±5.3) with most of women occurring in the age group 25-34 years accounting for 68 (64.76%). The most common clinical anatomical pattern was the ampulla 48(45.7%) and the least was abdominal pregnancy. The most common management modality used was Salpingectomy 68(64.8%) and the least was abdominal evacuation of conceptus materials in 2(1.9%). On management outcomes 104(99.1%) were treated and recovered with one (0.9%) maternal death. The majority of patients 75(71.4%) had blood transfusion especially in those who had shock index of more 0.9 and early management outcomes encountered were intractable bleeding intraoperative 26(24.8%), wound complications 9(8.6%), paralytic ileus 8(7.6%), visceral injury3(2.8%), Fever/pyrexia12(11.4%) and hospital stay of more than 7 days in 14(13.3%). Tubal pregnancy is the commonest EP (71.4%) with non tubal 28.6% and the ampulla 45.6% being the most clinical anatomical pattern encountered in the study, the leading cause of morbidity was intractable bleeding intraoperative 26(24.8%), followed by hospital stay of more than 7 days in 14(13.3%)with complications being likely more in non tubal pregnancy than in tubal EP. The encouragement of early health seeking, early diagnosis and timely referral to hospital is needed to decrease the rate of tubal rupture and the resulting morbidity and mortality. During EP management much attention should be given to patient with non tubal ectopic pregnancies since they are associated with adverse early management outcomes.
dc.language	en
dc.publisher	The University of Dodoma
dc.subject	Ectopic pregnancy
dc.subject	EP
dc.subject	Iringa regional referral hospital
dc.subject	Tubal pregnancy
dc.subject	Amenorrhea
dc.subject	Culdocentesis
dc.subject	Laparotomy
dc.subject	Salpingectomy
dc.subject	Salpingoophorectomy
dc.subject	Hysterectomy
dc.subject	Oophorectomy
dc.subject	Maternal mortality
dc.title	Clinical anatomical patterns and associated early management outcomes of ectopic pregnancy among pregnant women at Iringa regional referral hospital
dc.type	Dissertation