Ruptured tubal pregnancy in Makurdi, north central Nigeria.

BACKGROUND: Ruptured tubal pregnancy remains a major cause of early foetal wastage and maternal mortality in Nigeria and other developing countries. This study was done to determine the incidence, predisposing factors, clinical presentation and management options of ruptured tubal pregnancy at the Federal Medical Centre Makurdi. METHODOLOGY: A retrospective descriptive study of 35 cases of ruptured tubal pregnancy managed at the Federal Medical Centre, Makurdi, between January 2004 and December 2006 was conducted. RESULTS: The incidence of ruptured tubal pregnancy was 0.87% of total births (1 in 114 deliveries) and accounted for 94.6% of all ectopic pregnancies. There was a rising trend in the incidence of ruptured tubal pregnancy from 0.65% in 2004 to 1.09% in 2006. Identified risk factors include previous pelvic infection and previous induced abortions. Abdominal pain (100%), vaginal bleeding (65.7%), dizziness (62.9%) and amenorrhoea (57.1%) were the commonest symptoms. The ampulla was the site of rupture in 27(77.1%) patients. All patients had laparotomy. Unilateral total salpingectomy was done in 31(88.5%) patients. There was no maternal death in the cases managed. CONCLUSION: The incidence of ruptured tubal pregnancy is relatively low at the Federal Medical Centre Makurdi. Health education of women in the reproductive age on safe sex and eradication of unsafe abortion and early treatment of pelvic infections will prove useful preventive measures.