Ectopic pregnancy in African developing countries

Authors: Goyaux, Nathalie1; Leke, Robert2; Keita, Namory3; Thonneau, Patrick1

Source: Acta Obstetricia et Gynecologica Scandinavica, Volume 82, Number 4, April 2003 , pp. 305-312(8)

Publisher: Informa Healthcare

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Abstract:

Objective.

We have reviewed the scientific literature on ectopic pregnancy (EP) in African countries published over the past 20 years and available from several databases (MEDLINE, EMBASE, POPLINE, and Cochrane Fertility Regulation Group), with the aim of painting a complete picture of the situation (incidence, risk factors, diagnosis, treatment, and complications). Results.

Although hospital-based African studies indicate EP incidence has probably increased in Africa in recent decades, major methodological limitations in the published literature make it impossible to draw formal conclusions concerning the incidence of EP in Africa in recent years. As in industrialized countries, pelvic inflammatory disease (PID) associated with sexually transmitted diseases (STDs) must be considered as the most important risk factor for EP in developing countries. In African developing countries, a majority of hospital-based studies have reported EP case fatality rates of around 1–3%, 10 times higher than that reported in industrialized countries. Late diagnosis, leading in almost all cases to major complications, and emergency surgical treatments are key elements accounting for such high fatality rates in women suffering from EP in Africa. Conclusion.

EP should be considered a relevant public health indicator in developing countries, providing an overall picture of the capacity of a health system to deal with the diagnosis and treatment of emergency situations, especially in the field of obstetrics and gynecology.

Keywords: Africa; developing countries; ectopic pregnancy; maternal mortality

Document Type: Review Article

DOI: http://dx.doi.org/10.1034/j.1600-0412.2003.00175.x

Affiliations: 1: Human Fertility Research Group, Toulouse University, France, 2: Department of Obstetrics and Gynecology, Faculty of Medicine and Biomedical Sciences, University of Yaounde, Cameroon and 3: Department of Obstetrics and Gynecology, University Hospital of Donka, Conakry, Guinea

Publication date: April 1, 2003

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