Delay for Performing Laparotomy for Extra Uterine Pregnancy in N’Djamena Mother and Child University Hospital

Background: Ectopic pregnancy is defined as any pregnancy developed outside the uterine cavity. Objective: to study the relationship between the duration of laparotomy for EP and maternal prognosis. Patients and method. This was a prospective analytical study performed during a period of six (06) months, from May 1st to October 30, 2023, on delay time to perform laparotomy for EP in N’Djamena Mother and child University hospital (NMCUH). We included in this series all patients admitted for EP managed by laparotomy. Data were collected using Word software and analyzed using SPSS 18.0 version 2018. The p value statistical test was used to compare variables (p significant if ≤5%). Results: We recorded 92 cases of EP out of 5751 pregnancies, giving a frequency of 1.6%. Among patients diagnosed with EP, 76/92 (82.6%) had an indication of laparotomy. In 90.8%, the EP was ruptured. On admission, the diagnosis of EP was made within <15 min in 43.2% of cases. The time between diagnosis and indication for laparotomy was less than 15 minutes in 96% of patients. Blood products caused a delay in 63.1% of cases, with a delay of >1 hour in 15.8% of cases. The time to sign the consent allowing doctor to operate was >1 hour in 14.5% of cases. The operating room was unavailable in 34.2% of cases, with an unavailability of >1 hour in 17.1% of cases. Total salpingectomy was performed in 93.4%. Salpingotomy was performed in 6.6%. The lethality rate was 3.9% with significant value when the delay after indication and admission in the operating room is >1 (p value = 0.03). Conclusion: Various factors, such as the search for blood products, the time loss to sign the consent form and the unavailability of the operating room, delay the laparotomy, influence maternal prognosis. Anticipation on these factors is necessary in order to limit the proportion of delays.