Ruptured tubal pregnancy: predictors of delays in seeking and obtaining care in a Nigerian population
Authors Awoleke JO, Adanikin A, Awoleke A
Received 1 November 2014
Accepted for publication 10 December 2014
Published 27 January 2015 Volume 2015:7 Pages 141—147
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Elie Al-Chaer
Jacob O Awoleke,1 Abiodun I Adanikin,1 Adeola O Awoleke2
1Department of Obstetrics and Gynaecology, Ekiti State University, 2School of Nursing, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
Purpose: Morbidity and mortality from ruptured tubal pregnancies (RTPs) have been linked with delays in seeking and receiving care. Evaluation of the reasons for these delays and their contributions to maternal deaths is rarely done for women with RTPs in resource-constrained settings.
Patients and methods: This was a 3-year retrospective review of the case records of women with tubal pregnancies managed at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Clinical and sociodemographic parameters were obtained, including information on onset of symptoms and intervals between the symptoms and when help was sought and obtained at the hospital.
Results: There were 92 cases of tubal pregnancies, giving an incidence of 18 per 1,000 births. Most of the patients were married (74.7%), parous (64.9%), and urban dwellers (76.9%), and 11% were severely anemic on arrival. The case-fatality rate was 1.1% and 74.7% had delay in seeking care, while 82.4% of the women spent more than 2 hours after admission before surgical intervention. Rural dwellers (adjusted odds ratio 2.96, 95% confidence interval 1.08–8.36) and those without formal education (adjusted odds ratio 6.39, 95% confidence interval 1.06–67.30) had delays in seeking help, while problems with funds (χ2=7.354, P=0.005) and initial misdiagnosis (χ2=5.824, P=0.018) predicted delay in obtaining help at the hospital.
Conclusion: RTPs are common gynecological emergencies in our environment that are often associated with delayed decisions to seek help and obtain care. Efforts should be geared toward women’s education and financial independence, improved hospital accessibility, and better diagnostic skills.
Keywords: delay, ruptured tubal pregnancies, predictors, health care, Nigeria
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