Ectopic pregnancy : cause of many maternal deaths
- Posted on 02/08/2023 18:01
- Film
- By abelozih@sante-education.tg

Extract from the article: During a woman's pregnancy, the uterus is generally the organ that will house the foetus, which will be expelled from the uterine cavity on delivery. However, there are cases where the foetus is placed outside the uterine cavity. According to Dr Dédé
During
a woman's pregnancy, the uterus is generally the organ that will house the
foetus, which will be expelled from the uterine cavity on delivery. However,
there are cases where the foetus is placed outside the uterine cavity.
According to Dr Dédé Bénédicta Améwoui, an obstetrician-gynaecologist and head
of the Group Medical clinic in Lome, this is known as an extra-uterine
pregnancy (EUP). This is a very dangerous phenomenon for the mother, and is one
of the causes of maternal mortality in Togo if it is not treated early. A
number of factors contribute to the occurrence of ectopic pregnancy.
Extra
uterine pregnancy (EUP) is one of the rare but most dangerous conditions
encountered by women during pregnancy. « An ectopic pregnancy occurs
when the pregnancy develops outside the uterine cavity. In an extra-uterine
pregnancy, the pregnancy occurs outside the uterine cavity, particularly in the
fallopian tube », explains obstetric gynaecologist Dr Dédé Améwoui.
Causes
According
to gynaecologist Dr Dédé Améwoui, the risk factors for ectopic pregnancy
include all conditions and histories that impair the quality of the fallopian
tubes, or anything that can slow the development of the egg in the uterine
cavity. Other causes of EP include « genital infections, in vitro
fertilisation, a pelvic history of sexually transmitted diseases, and a history
of surgery on the fallopian tube. Smoking is also a major risk factor, with a
dose-response relationship », said Dr Benedicta Améwoui. The chances
of detecting an extra-uterine pregnancy are often very low. According to the
gynaecologist, EPs need to be diagnosed very early on. « It's a
three-pronged diagnosis: clinical, biological and ultrasound. As far as the
clinic is concerned, we very often see women with a delay of 2 to 3 days in
their periods. Others, on the other hand, have signs such as bleeding or pelvic
pain. If menstruation is delayed, a pregnancy test is ordered, but the most
important thing is the kinetics of plasma beta Hcg levels », informs
Dr Améwoui.
It
is important to note that in the case of an extra-uterine pregnancy, the
pregnancy begins outside the uterus. Apart from the fallopian tubes, an EP can
develop on an ovary, in the cervix, in the uterine horn or in the abdominal
cavity.This is what Sandrine, a 36-year-old housewife and cashier at a
microfinance centre in Lomé, has to say about her son's pregnancy. « It's
really lucky for me, because the doctors were able to detect the EP early on.In
the 2nd month of my pregnancy, I felt terrible pains in my lower abdomen.So I
went for an ultrasound scan, as I do for all my pregnancies, and that's when my
gynaecologist told me that I had an extra-uterine pregnancy, as my pregnancy
was progressing outside the uterus.I'd never heard of it before and it was only
with the help of my gynaecologist that I was able to be treated very early on ».
Like Sandrine, there are many women who know nothing about EPs and yet suffer
from them every day.Ectopic pregnancy is an emergency with many negative
repercussions on a woman's health.
Consequences
The
obstetric gynaecologist explains that in the case of EP, the tube becomes
elastic, with the possibility of rupture. « This leads to internal
haemorrhage in the mother's body ». The mother's chances of survival
are therefore very low if the EP is not discovered early.Mortality is therefore
the immediate consequence of the anaemia caused by the internal haemorrhage.
Prevent
ectopic pregnancy
However,
there are simple steps that can be taken to prevent ectopic pregnancy.For
gynaecologist Dédé Améwoui, an extra-uterine pregnancy can occur repeatedly if
the genital infection has not been properly treated in the patient. « It
is therefore important to avoid genital infections and pelvic inflammatory
disease, above all by practising good sexual behaviour and avoiding smoking.A
woman who has had an Extra Uterine Pregnancy should go for a check-up one and a
half months after treatment, to avoid the possibility of another EP »,
advised the specialist.
Abel
OZIH