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ABSTRACT
Introduction. Ectopic pregnancy is a serious gynaecological complication. Methotrexate is used to treat ectopic pregnancies. In Cameroon, surgery is the treatment of choice. We therefore studied the epidemiology, indications, outcome and success rate of medical treatment of ectopic pregnancy in three reference hospitals in Douala. Materials and methods. A five-year cross-sectional study was carried out in three hospitals in Douala from January 2018 to December 2022. All files presenting an unruptured ectopic pregnancy treated with methotrexate were recruited. Variables included sociodemographic, obstetric history, clinical presentation, paraclinical examinations and complications. Bivariate analysis was used to test the association between predictor variables and medical treatment success. Results. 66 participants received methotrexate as treatment for ectopic pregnancy. The average age was 30.05 ± 5.33 years and the gestational age was 49.88 ± 16.73 days. The most common clinical signs were pelvic pain, abnormal vaginal bleeding and amenorrhea (30.3 %). All patients had a pelvic ultrasound and b-hcg dosage. The prevalence of medical treatment was 13%, a success rate of 63.6 %. The age of the mother, the nulliparous woman, a primigravida, having a cumulative sexual partner, a gestational sac of 1 cm, beta-HCG <5000 miu/ml increased the chances of success of medical treatment. 18.2 % of adverse effects. Conclusion. Few ectopic pregnancies are treated medically. The effectiveness of the treatment is acceptable with few adverse effects.
RÉSUMÉ
Introduction. La grossesse extra-utérine est une complication gynécologique grave. Le méthotrexate est utilisé pour traiter les grossesses extra-utérines. Au Cameroun, la chirurgie est le traitement de choix. Nous avons étudié l'épidémiologie, les indications, l’issue et le taux de réussite du traitement médical de la grossesse extra-utérine dans trois hôpitaux de référence à Douala. Matériels et méthodes. Une étude transversale sur cinq ans a été réalisée dans trois hôpitaux de Douala de janvier 2018 à décembre 2022. Tous les dossiers présentant une grossesse extra-utérine non rompus traitées par méthotrexate ont été recrutés. Les variables comprenaient des variables socio-démographiques, les antécédents obstétricaux, la présentation clinique, les examens cliniques para cliniques et complications. Une analyse bivariée a été utilisée pour tester l'association entre les variables prédictives et le succès du traitement médical. Résultats. 66 participants ont reçu du méthotrexate comme traitement pour la grossesse extra-utérine. L’âge moyen était de 30,05 ± 5,33 ans et l’âge gestationnel de 49,88 ± 16,73 jours. Les signes cliniques les plus représentés étaient la douleur pelvienne, saignement vaginaux anormaux et aménorrhée (30,3 %). Toutes les patientes ont fait une échographie pelvienne et dosage de béta-HCG. La prévalence du traitement médicale était de 13%, un taux de réussite de 63,6 %. L'âge de la mère, la nullipare, une primigeste, avoir un partenaire sexuel cumulé, un sac gestationnel de 1 cm, béta-HCG <5000 mUI/ml augmentaient les chances de succès du traitement médical. 18,2 % des effets indésirables. Conclusion. Peu de grossesses extra-utérines sont traitées médicalement. L’efficacité du traitement est acceptable avec peu d’effets indésirables.

Keywords

Epidemiology, indications, results, evolution, medical treatment

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Moustapha, B., Ngaha Yaneu, J., Suh Manka Afanwi, C., Tatah Neng, H., Kamdem, D., Ngalame, A., Essome, H., Nguefack Tchente, C., & Mboudou, E. (2024). Medical Treatment of Ectopic Pregnancy in Douala: Indications, Results and Outcome: Traitement Médical de la Grossesse Ectopique à Douala : Indications Résultats et Évolution. HEALTH SCIENCES AND DISEASE, 25(3). https://doi.org/10.5281/hsd.v25i3.5408
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