EC Gynaecology

Ectopic pregnancy, defined as a fertilized ovum that implants outside of the uterine cavity, the commonest site being the uterine tube, occurs in about 2.0% of reported pregnancies. It’s a major life-threatening pregnancy complications and a leading cause of first trimester pregnancy-related deaths.

Due to increased awareness, advances in diagnostic technologies and improved access to health care, more cases of ectopic pregnancies are being diagnosed early, high resolution transvaginal ultrasound combined with quantitative sensitive β-hCG being a useful tool in this regard. Early diagnosis has made it possible for a wider choice of therapeutic options. There is a growing trend towards non-invasive or conservative management approaches for unruptured ectopic pregnancy, to reduce related costs, morbidity and mortality and preserve fertility. This may include medical management, for which systemic methotrexate, is an acceptable option with good success rates, preservation of future fertility, it’s cost-effective and with no long term negative impact on the patient’s wellbeing.

While this has been used widely in the developed regions of the world, its use in developing regions including sub-Saharan Africa, has remained quite low or none, for various reasons. As a result thereof, related publications from the region are non-existent.

A 32 year old nulliparous lady, currently pregnant, following natural conception after successful treatment with methotrexate, in East Africa, is presented with review of literature.

 Keywords: Tubal Pregnancy; Methotrexate; Ectopic Pregnancy; β-hCG

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