Associated factors for intrauterine ectopic pregnancy: a case-control study

Abstract

Background: Intrauterine ectopic pregnancies are uncommon but its mortality is about 6-7 times higher than in tubal EP. The aim of this study was to find out the prevalence of intrauterine ectopic pregnancies and identify factors associated with their occurrence.

Methods: We conducted a case-control study on a 5-years period at the Obstetrics & Gynaecology departments of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital and Yaoundé Central Hospital. Cases were files of patients with Intrauterine ectopic pregnancies and controls were those with tubal pregnancies (ratio 1:3). Descriptive statistics followed by logistic regression analyses done using the software SPSS version 25.0, statistical significance set at p-value < 0.05.

Results: We identified a total of 1014 ectopic pregnancies, amongst which 914 (90.1%) tubal, 78 (7.7%) intrauterine (cornual or interstitial), 13(1.3%) ovarian, and 9(0.9%) abdominal. Only 41 cases were included for analyses (37 excluded) against 123 controls, giving a study population of 164 patients. After multivariate logistic regression analysis, women within age groups 31 - 40 years (aOR = 2.42, 95% CI: 1.23 - 4.74, p = 0.01) and those with per-operative finding of previous ipsilateral salpingectomy (aOR = 6.41, 95% CI: 1.07 - 60.51, p = 0.042) had higher odds of developing cornual or interstitial Pregnancy. Whereas women with past history of PID (aOR = 0.38, 95% CI: 0.17 - 0.82, p = 0.014) were less likely to experience Intrauterine ectopic pregnancies.

Conclusion: Intrauterine ectopic pregnancies is fairly common. Risk of cornual or interstitial pregnancy increases with age ≥31 years, previous ipsilateral salpingectomy.