Evaluation of Sonographic Features of Ectopic Pregnancy at Mbagathi District Hospital

Abstract

Background: Ectopic pregnancy is a life threatening gynecological emergency that accounts for a significant proportion of maternal deaths in the developing world. Gynecological and obstetric Ultrasound examinations play a central role in early detection of ectopic pregnancy and its related complications in early pregnancy. Therefore, there is need to assess the pattern of sonographic findings among patients with ectopic gestation in order to raise awareness among sonographers about the salient diagnostic criteria of the scourge of ectopic pregnancy.

Aims and Objectives: Evaluate the pattern of sonographic findings among patients with ectopic gestation at the Mbagathi District Hospital. Specifically, to establish the socio-demographic characteristics of patients with ectopic gestation, determine the prevalence of ectopic gestation, and to document the most prevalent sonographic feature of ectopic pregnancy among patients at the Mbagathi District Hospital.

Methods: Three-month cross-sectional survey of 87 patients that underwent ultrasound examination and had ectopic pregnancy at the Mbagathi District Hospital.

Findings: The youngest participant diagnosed with ectopic pregnancy was 18 years old while the oldest was forty 43 years. On basis of age group of respondents there was a statistically significant difference ( p > 0.01) in the distribution with the age group of 31-40 years, accounting for the largest proportion (n= 43) followed by age group of 21-30 years (n=13)  while  age groups of 10- 20 years and 41-50 years each had six cases. Thirty one per cent of all respondents had previous history of ectopic pregnancy.  Among those with history of ectopic pregnancy, 82.45% were diagnosed with current ectopic pregnancy. The most common sonographic finding among participants diagnosed with ectopic pregnancy was extra uterine gestation sac with viable fetal pole with a prevalence of 39.7% followed by adnexal  mass with 36.8%; tubal ring 14.7% and  4.4% for both  Pseudo gestation sac and intraperitoneal hemorrhage.

Conclusion: The most affected age group is 31-40years with the largest proportion of patients with ectopic pregnancy at 43 out of 87. This concurs with earlier studies by Ates, Job, & Fernandez (1991) thus giving credence to the postulate that age-related changes in tubal function might delay ovum transport and result in tubal implantation in mature females.

Recommendation: Routine pelvic ultrasound in first trimester is important for early detection of ectopic pregnancy in order to reduce maternal mortality related to the same owing to the seemingly high incidence of ectopic gestations at the Mbagathi District Hospital. A further study to look at all hospital data on ectopic gestation in Nairobi County is recommended in order to come up with a realistic prevalence of ectopic gestations among pregnant women.