TITLE:
Evaluation of Spontaneous Fertility after Medical Treatment of Tubal Ectopic Pregnancy in Two Hospitals in the City of Yaounde
AUTHORS:
Noa Ndoua Claude Cyrille, Tchedele Guidebta Hilary, Nyada Serge Robert, Astrid Ruth Ndolo Kondo, Ayissi Gregory, Ngo Dingom Anne Madye, Tompeen Isidore
KEYWORDS:
Ectopic Pregnancy, Maternal Morbidity
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.14 No.1,
January
31,
2024
ABSTRACT: Background: Ectopic pregnancy is a major cause of maternal morbidity and mortality,
estimated to occur in 1% - 2% of
pregnancies worldwide. This condition also has an adverse effect on the
fertility prospects of women who experience it. Objective: To determine the outcomes of subsequent spontaneous fertility
after medical treatment of patients with methotrexate (MTX) in patients
with ectopic pregnancy at two university teaching hospitals of Yaounde. Methodology: We carried out a cross-sectional study with retrospective data collection
in two university teaching hospitals of Yaounde during a six years period from 1st January 2015 to 31st May 2021. Seventy records of patients who had medical treatment for ectopic
pregnancy were included in this study. Statistical analysis was performed using
SPSS. 23. The Chi-2 statistical test was used to compare
qualitative variables. Binary logistic regression method was performed to
identify independent risk factors associated with infertility after medical
treatment of tubal ectopic pregnancy (TEP). The significance level was set at
0.05. Results: The mean age in our study population was 27.8 ± 3.8
years. According to the past medical history, 52.9% had a pelvic inflammatory
disease (PID) and the most frequently germ found was C. trachomatis (47.1%).
Almost 15% of our study population had previous surgery for EP. The median
Fernandez score was 11 with a minimum score of 4 and a maximum score of 13. The
route of administration of methotrexate was intramuscular in all our patients,
and the single-dose protocol was used most frequently (58.6%). After medical
treatment of the EP, we found a spontaneous conception rate of 58.6%. After
multivariate analysis, we were unable to confirm that there was an association
between a history of sexually transmitted infections (STIs) and fertility
prognosis. Conclusion: The spontaneous fertility rate after medical
management of EP was 58.6%, of which 73.2% were term pregnancies and 14.6% were
recurrent ectopic pregnancies.