Treatment Outcomes of Ectopic Pregnancy Among Women Managed Medically at St. Paul's Hospital Millennium Medical College Addis Ababa/ Ethiopia
Abstract
Background: Ectopic pregnancy, a pregnancy in which the embryo implants outside the endometrial cavity, is an important cause of maternal mortality, especially in developing countries. It can be managed via multiple approaches including medical management using methotrexate. In Ethiopia, limited evidence exists regarding the treatment outcome of its medical management.
Methods: This retrospective study was conducted based on medical records of ectopic pregnancy patients managed medically using methotrexate. The data of all women who had unruptured ectopic pregnancy and managed medically in the study period at St. Paul’s Hospital Millennium Medical College were included in the study. Data were extracted from patients medical records using a structured and pretested format by trained data collectors and analyzed using SPSS software.
Results: During the period of study, 81 women among patients diagnosed with unruptured ectopic pregnancy were managed medically using methotrexate with the success of 93.8% (n=76). Methotrexate was administered intramuscularly to all patients in either a single dose (60.5%, n=49) or multiple dose regimen (39.5%, n=32). Although 53% (n=26) of patients on single dose regimen required second dose and 25% (n=8) on multiple dose regimens did not complete all 4 doses, the success rates were comparable between the two groups of regimen. Five out of the 81 patients underwent surgical intervention for either ectopic rupture or persistent ectopic mass. There was no fatal complication.
Conclusion: Methotrexate is a successful and safe alternative to surgical management of unruptured ectopic pregnancy in our settings. It should be given a trial in patients who meet the selection criteria in a setting ready for emergency surgical intervention and blood transfusions.