Original Research

An audit of the management of ectopic pregnancies in a district hospital, Gauteng, South Africa

Doudou K. Nzaumvila, Indiran Govender, Gboyega A. Ogunbanjo
African Journal of Primary Health Care & Family Medicine | Vol 10, No 1 | a1757 | DOI: https://doi.org/10.4102/phcfm.v10i1.1757 | © 2018 Dou Dou Nzaumvila, Indiran Govender, Gboyega Ogunbanjo | This work is licensed under CC Attribution 4.0
Submitted: 08 February 2018 | Published: 30 October 2018

About the author(s)

Doudou K. Nzaumvila, Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University, South Africa; and, Dr George Mukhari Academic Hospital, Ga-Rankuwa, South Africa
Indiran Govender, Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University, South Africa
Gboyega A. Ogunbanjo, Department of Family Medicine and Primary Health Care, Sefako Makgatho Health Sciences University, South Africa; and, Dr George Mukhari Academic Hospital, Ga-Rankuwa, South Africa


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Abstract

Background: Ectopic pregnancy (EP) is a life-threatening condition; at Odi Hospital, approximately 7–10 EPs are managed weekly. Our study is the first to assess the management of this life-threatening condition at Odi Hospital.

Aim: This study aimed to determine the incidence of EP and to assess the profile of women who presented with EP at Odi District Hospital from 01 January 2010 to 31 December 2014.

Setting: The study was conducted at Odi District Hospital, located in Mabopane, a township in Gauteng province, 45 km north of Tshwane, South Africa (SA).

Methods: This was a cross-sectional study.

Results: We analysed 263 completed patient records. The incidence rate was 22 per 1000 live births. The mean age was 28.9 years (SD ± 6.09), 57% were within the age group of 25–34 years, 90.9% were single and 85.2% were unemployed. Abdominal pain was the most common presenting complaint (81.1%). Ninety-nine (37.8%) were in a state of haemorrhagic shock. Possible risk factors were not documented in the patient files for 95%. A third (34.2%) were operated on within 4 hours of consultation. Early management was associated with poor record-keeping (p = 0.02). There was a delay in confirming the diagnosis in 48.7%. It was associated with gestational age (p = 0.0017), previous abdominal surgery (p = 0.0026), normal haemoglobin level at the time of consultation (p = 0.0024), considerable haemoperitoneum at operation (p < 0.00001) and per vaginal bleeding (p = 0.003).

Conclusion: The study highlighted the need to emphasise the importance of good record-keeping and documentation in patients, as well as the urgent need for ultrasound skills training among clinicians to implement the Essential Steps in Managing Obstetric Emergencies programme at this hospital to improve the management of EP and other obstetric emergencies.


Keywords

audit; management; ectopic pregnancies; life-threatening condition

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