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
References
[1]
Orazulike, N.C. and Konje, J.C. (2013) Diagnosis and Management of Ectopic Pregnancy. Women’s Health, 9, 373-385. https://doi.org/10.2217/WHE.13.35
[2]
Baggio, S., Garzon, S., Russo, A., Ianniciello, C.Q., Santi, L,. Laganà, A.S., et al. (2021) Fertility and Reproductive Outcome after Tubal Ectopic Pregnancy: Comparison among Methotrexate, Surgery and Expectant Management. Archives of Gynecology and Obstetrics, 303, 259-268. https://doi.org/10.1007/s00404-020-05749-2
[3]
Akande, V., Turner, C., Horner, P., Horne, A. and Pacey, A. (2010) Impact of Chlamydia trachomatis in the Reproductive Setting: British Fertility Society Guidelines for Practice. Human Fertility, 13, 115-125.
https://doi.org/10.3109/14647273.2010.513893
[4]
Asgari, Z., Chegini, V., Hosseini, R., Mohajeri, M. and Ansari, I. (2021) Fertility Outcomes Subsequent to Medical and Surgical Treatment for Ectopic Pregnancy: A Retrospective Cohort Study in Iran. International Journal of Reproductive BioMedicine, 19, 881-888. https://doi.org/10.18502/ijrm.v19i10.9820
[5]
Kenfack, B., Nguefack-Tsague, G., Ateudjeu, J., Che, G.A. and Mboudou, E.T. (2015) Fertility after Ectopic Pregnancy in a District Hospital in Cameroon. International Journal of Gynecology & Obstetrics, 130, 165-168.
https://doi.org/10.1016/j.ijgo.2015.02.027
[6]
Kenfack, B., Noubom, M., Bongoe, A., Tsatedem, F.A., Ngono, M., Tsague, G.N., et al. (2012) La grossesse extra-utérine dans une région semi-rurale en Afrique: Aspects épidémiologiques, cliniques et thérapeutiques à propos d’une série de 74 cas traités à l’Hôpital de District de Sangmelima au Sud-Cameroun. Pan African Medical Journal, 13, 71.
[7]
Dohbit, J.S., Foumane, P., Kapche, M.D., Mboudou, E.T., Doumbe, M. and Doh, A.S. (2010) Grossesse Extra-Uterine a l’hopital regional de bafoussam: Aspects épidémiologiques, cliniques et thérapeutiques. Clinics in Mother and Child Health, 7, 1189-1193. https://www.ajol.info/index.php/cmch/article/view/60568
https://doi.org/10.4303/cmch/C101977
[8]
Felix, E., Ngo, U.M.E., Kondo, A.N., Fize, S.K.S., Ayissi, G. and Mbu, E.R. (2019) Sexual Risk Behaviour in a Student Population of the University of Yaoundé I, Cameroon. Revue de médecine et de pharmacie, 9, 1050-1056.
[9]
Assouni Mindjah, Y.A., Essiben, F., Foumane, P., Dohbit, J.S. and Mboudou, E.T. (2018) Risk Factors for Ectopic Pregnancy in a Population of Cameroonian Women: A Case-Control Study. PLOS ONE, 13, e0207699.
https://doi.org/10.1371/journal.pone.0207699
[10]
Huang, C.C., Huang, C.C., Lin, S.Y., Chang, C.Y.Y., Lin, W.C., Chung, C.H., et al. (2019) Association of Pelvic Inflammatory Disease (PID) with Ectopic Pregnancy and Preterm Labor in Taiwan Region: A Nationwide Population-Based Retrospective Cohort Study. PLOS ONE, 14, e0219351.
https://doi.org/10.1371/journal.pone.0219351
[11]
Hao, H.J., Feng, L., Dong, L.F., Zhang, W. and Zhao, X.L. (2023) Reproductive Outcomes of Ectopic Pregnancy with Conservative and Surgical Treatment: A Systematic Review and Meta-Analysis. Medicine (Baltimore), 102, e33621.
https://doi.org/10.1097/MD.0000000000033621
[12]
Gervaise, A., Masson, L., de Tayrac, R., Frydman, R. and Fernandez, H. (2004) Reproductive Outcome after Methotrexate Treatment of Tubal Pregnancies. Fertility and Sterility, 82, 304-308. https://doi.org/10.1016/j.fertnstert.2004.04.023
[13]
Guvendag Guven, E.S., Dilbaz, S., Dilbaz, B., Aykan Yildirim, B., Akdag, D. and Haberal, A. (2010) Comparison of Single and Multiple Dose Methotrexate Therapy for Unruptured Tubal Ectopic Pregnancy: A Prospective Randomized Study. Acta Obstetricia et Gynecologica Scandinavica, 89, 889-895.
https://doi.org/10.3109/00016349.2010.486825
[14]
Yang, C., Cai, J., Geng, Y. and Gao, Y. (2017) Multiple-Dose and Double-Dose versus Single-Dose Administration of Methotrexate for the Treatment of Ectopic Pregnancy: A Systematic Review and Meta-Analysis. Reproductive Biomedicine, 34, 383-391.
https://doi.org/10.1016/j.rbmo.2017.01.004
[15]
Düz, S.A. (2021) Fertility Outcomes after Medical and Surgical Management of Tubal Ectopic Pregnancy. Acta clinica Croatica, 60, 347-353.
https://doi.org/10.20471/acc.2021.60.03.02
