Facteurs associés à l’échec du traitement médical de la grossesse extra-utérine: cas de l’Hôpital Gyneco-Obstétrique et Pédiatrique de Yaoundé

INTRODUCTION: the purpose of this study was to identify factors associated with the failure of medical treatment for ectopic pregnancy (EP) in women at the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital. METHODS: we conducted a case-control study using a retrospective data collection over a 10-year period from January 1(st) 2008 to December 31(st) 2017. Our study included all patients treated for EP; the study group was composed of patients in whom medical treatment had been unsuccessful while the control group was composed of patients in whom medical treatment had been successful. The variables studied were: socio-demographic, clinical, paraclinical and therapeutic features. Consecutive and complete sampling were used. Multivariate analysis was performed. RESULTS: we enrolled 92 patients, including 23 cases and 69 controls. The variables associated with the failure of medical treatment for EP after univariate analysis were: initial β-HCG (beta-human chorionic gonadotropin) level > 10000IU/L (OR=3.05; P=0.031), β-HCG level on day 4 > 10000IU/L (OR=7.15;P=0.000), β-HCG level on day 7 > 10000UI/L (OR=20; P=0.000), Fernandez score ≥ 13 (OR=3.09;P=0.020), the presence of fetal heart activity (OR=2.8; P=0.036), a history of voluntary abortion (OR=2.67;P=0.043) and primary level of education. (P=0.013). After multivariate analysis, predictors were: initial β-HCG level>10000 IU/L (OR=8.97; P=0.004), β-HCG level on day 4>10000 IU/L (OR=8.44;P= 0.007), Fernandez score ≥ 13 (OR=1.12;P=0.005), and the presence of fetal heart activity (OR=6.09;P=0,026). CONCLUSION: at the Yaoundé Gynaecology, Obstetrics and Pediatrics Hospital predictors of failure of medical treatment for EP were related to initial β-HCG level and fetal viability.