Ectopic pregnancy in Abha, Saudi Arabia. A continuing conundrum

OBJECTIVE: To determine the incidence of ectopic pregnancy in Abha, in the south-western region of Saudi Arabia and to evaluate the relevance of the known risk factors.

METHODS: Eighty-two women with histologically confirmed ectopic pregnancies, managed in Abha Maternity Hospital over a three-and-a-half year period, were retrospectively studied.

RESULTS: The incidence of ectopic pregnancy was 0.74 per 100 live births. Most (56%) of our patients were within the 21-30 age group. Parous women constituted 56% and nulliparous patients constituted 21% of the study group. No previous history of abortion was found in 60% of the patients. Fourteen (17%) had used the intra uterine contraceptive device and 5% had a history of previous ectopic pregnancy. There were 3 cases of heterotopic pregnancies in the series. The right and left fallopian tubes were equally affected. Salpingectomy (90%) was the most frequent definitive surgical procedure performed, and 15% of the patients required blood transfusion. There was no obvious seasonal variation and no maternal death was reported.

CONCLUSION: The incidence of ectopic pregnancy appears to be comparatively low in our community and the risk factors do not seem to be clearly defined. A nation-wide multicenter survey to determine the effect of climatic factors and to check, as routine, Chlamydia trachomatis serology in suspected cases of ectopic pregnancy, may be desirable. Without these determinations, ectopic pregnancy and possible preventive measures may continue to remain a conundrum.