CHALLENGES IN THE EARLY DIAGNOSIS AND MANAGEMENT OF ECTOPIC PREGNANCY: A PROSPECTIVE STUDY IN TWO HEALTH FACILITIES IN YAOUNDE, CAMEROON.

Abstract

Introduction: An ectopic pregnancy (EP) occurs when the blastocyst implants at a site other than the normal uterine cavity. It can greatly affect the reproductive capacity of the woman, especially when there is a delay in diagnosis and management. Despite availability of diagnostic tools, most cases are diagnosed late, and management is predominantly by invasive surgery. This study
aims to determine challenges to early diagnosis and management of EP.
Materials and methods: We conducted a prospective crosssectional study from December 2021 to July 2022 among EP patients managed at the Yaounde Central Hospital and the Yaounde Gynaeco-Obstetric and Pediatric Hospital. The course patients followed from onset of symptoms to point of diagnosis and management was assessed to determine reasons for delayed diagnosis and management. Data was entered and analyzed using Epi Info version 7.2.5.0. Association between possible explanatory variables for misdiagnosis and delays in diagnosis were determined by logistic regression analysis. P values < 0.05 were considered signicant.
Results: We registered 113 EP cases out of 2,888 deliveries giving a frequency of 3.9%. Age of patients ranged between 17 and 44
years with a median of 27. Delays from rst symptoms to consultation varied between one and sixty days with a median of six
days. Misdiagnosis was made at the rst health unit in 46.0% of cases. Factors associated with misdiagnosis were; consultation by
nurse [OR = 5.88, P < 0.01]; no diagnostic tests [OR=13.0, P <0.01], and not doing a pregnancy test [OR=2.8, P = 0.04]. Invasive surgery
was the most used management method (77.9%).
Conclusion: Late consultation and misdiagnosis delay diagnosis and management of EP in Yaounde. Invasive surgery remains the
main method used. Women should be encouraged to start antenatal care early and EP should always be considered as a differential in