Maryam M., 19

Maryam, from a displaced community in the suburbs, was in JSS3 before being displaced to Damaturu six years ago. She dreams of becoming a banker and enjoys playing board games. She is known for being respectful and honest. Six months ago, she was married to a 24-year-old local vigilante who was killed by insurgents during a joint military operation. Maryam presented with three months of amenorrhea, lower abdominal pain, and vaginal bleeding. She was initially seen at a primary healthcare center where she was found to be pregnant. Three days after the onset of pain and bleeding, she suddenly collapsed and was rushed to the hospital by her neighbors. Upon examination, she was diagnosed with a ruptured ectopic pregnancy. A ruptured ectopic pregnancy is a medical emergency where a fertilized egg implants outside the uterus, typically in a fallopian tube. As the pregnancy grows, it can cause the tube to burst, leading to severe internal bleeding, lower abdominal pain, and potentially life-threatening complications. Immediate surgical intervention is necessary to manage the rupture and control the bleeding.

Maryam had an emergency laparotomy done under general anaesthesia on account of ectopic pregnancy. She had 1 unit of blood transfused intra-operatively and 2 units transfused post-operatively. She had the following post-op medications: Intravenous Fluid N/S 1L 8hourly for 24hours, IV Tandak 1.5g 12hourly for 48hours, IV Flagyl 500mg 8hourly for 48 hours, IV Ciprofloxacin 200mg 12hourly for 48hours, IV Pentazocin 30mg 8hourly, IM Diclofenac 75mg 12hourly. She commenced ambulation and oral sip after 24hours. The surgical site is well apposed with evidence of good healing. She has been regular with her medications. She is doing so well and has no fresh complain. Later, her injectable drugs was converted to orals and discharged home with follow-up appointment of 1week.

Ectopic pregnancy requires prompt treatment due to the risks it poses.If the ectopic pregnancy is detected early and there's no significant risk of rupture, a drug called methotrexate can be used. Methotrexate stops the growth of the embryo, and the body eventually absorbs the pregnancy tissue. This option avoids surgery and is often the first line of treatment when conditions allow. In cases where the ectopic pregnancy is more advanced, or there's a risk of rupture (which can cause severe bleeding), surgery is necessary. The most common surgical procedure is laparoscopy, a minimally invasive surgery.