ISSN: 2474-9230
Authors: Maina MW*, Karanja JG, Michoma PM, Ndavi M an Lubano K
Context: Ectopic pregnancy remains a significant cause of morbidity and mortality in the developing countries, where mortality rates are 10 times higher than in the developed countries. In Kenya, there is however no recent data on ectopic pregnancy. Objective: We sought to identify if using an emergency contraceptive pill predisposes to ectopic pregnancy and assess other risk factors for ectopic pregnancy at the Kenyatta National Hospital. Methods: We conducted a case-control study of 120 consecutively sampled women matched for age diagnosed with ectopic pregnancy. Data were analyzed using a statistical package for the social sciences (SPSS software) [version 18.0]. Multivariate logistic regression analysis was performed to calculate the odds ratios (OR) and the corresponding 95% confidence intervals (CI). Results: Of the 120 cases and 120 controls recruited, 27.5% of the cases and 2.5% of the controls had taken Levonogesterol emergency contraceptive (LNG-EC) pill during the menstrual cycle leading to the current pregnancy. Of the cases, 72.7% took the LNG-EC within 24hrs after coitus, while all the controls took the pill within 24-48 hrs. The risk of ectopic pregnancy (EP) increased 12-fold in women who had used LNG-EC (OR=12.44, 95% CI 3.1-49.84) after adjusting for other confounders. EP was associated with an early sexual debut (p= 0.039), and a history of subfertility/infertility (OR=6.87, 95% CI 2.14-22.03). Conclusions: Progesterone only emergency contraceptive pill is as a risk factor for ectopic pregnancy and should be included in the client information leaflet in the drug package insert.
Keywords: Progesterone Only Emergency Contraceptive Pill; Ectopic Pregnancy; Risk Factors; Morbidity; Mortality
