Binta A., 27

Binta is a 27-year-old woman who lives with her husband, Musa, in Yusufari Village, Yobe State, Nigeria. They reside in a modest mud-room house with very limited access to basic amenities. Their living conditions reflect the financial challenges they face on a daily basis. Musa is a local farmer and the family's sole breadwinner. His farming activities provide an average monthly income of only ₦8,900, which is barely enough to cover their basic needs, including food and household expenses. The patient is a full-time housewife and depends entirely on her husband's earnings for her daily needs and healthcare. Binta A 27-year-old woman, Gravida 2 Para 1 (G2P1), presented to the hospital with severe lower abdominal pain, dizziness, fainting episodes, and vaginal bleeding. She reported being approximately 12 weeks pregnant and had experienced progressively worsening abdominal pain over the past few days. On arrival, she appeared pale, weak, and was in severe distress. Her blood pressure was low, and her pulse rate was rapid, indicating significant internal bleeding. Following an urgent clinical assessment, laboratory investigations, and an ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy at 12 weeks' gestation.

Binta was immediately admitted to the emergency unit in a critical condition and managed according to standard emergency obstetric protocols. Initial resuscitation included securing intravenous access, administering intravenous fluids, oxygen therapy, and cross-matching blood for urgent transfusion due to significant internal bleeding. After stabilization, she underwent an emergency laparotomy with salpingectomy (removal of the ruptured fallopian tube) to control the hemorrhage and remove the ectopic pregnancy. Following surgery, she was closely monitored in the ward. She received blood transfusions to correct blood loss, intravenous antibiotics to prevent postoperative infection, analgesics for pain control, and supportive care. Her vital signs gradually stabilized, her abdominal pain improved, and the surgical wound healed without complications. She was counseled on the importance of follow-up care, family planning, and early antenatal booking in future pregnancies to reduce the risk of recurrent ectopic pregnancy. Medications administered included: Intravenous Normal Saline and Ringer's Lactate for fluid resuscitation. Packed Red Blood Cells (Blood Transfusion) to replace blood loss. Ceftriaxone 1 g IV once daily for infection prevention. Metronidazole 500 mg IV every 8 hours, followed by oral therapy. Paracetamol 1 g every 6–8 hours as needed for pain and fever. Diclofenac 75 mg IM or oral NSAIDs (if not contraindicated) for postoperative pain relief. Ferrous Sulphate 200 mg orally three times daily and Folic Acid 5 mg once daily to treat postoperative anemia and support recovery. The patient responded well to treatment and was discharged in stable condition with follow-up appointments, instructions on wound care, completion of prescribed medications, and advice to seek early medical attention in any future pregnancy. With continued adherence to treatment and follow-up, she is expected to make a good recovery.

Doctor's Opinion Binta is a 27-year-old Gravida 2 Para 1 (G2P1) diagnosed with a ruptured ectopic pregnancy at 12 weeks' gestation, a life-threatening obstetric emergency associated with significant internal bleeding. She presented in a hemodynamically unstable condition due to hemorrhage following rupture of the fallopian tube. Immediate resuscitation with intravenous fluids, blood transfusion, and emergency surgical intervention were necessary to control the bleeding and save her life. Prompt management is essential to prevent hemorrhagic, hypovolemic shock, multiple organ failure, pelvic adhesions, future infertility and death. The patient will require close postoperative monitoring, correction of anemia, pain management, and follow-up care to ensure complete recovery. The prognosis is good because the patient received timely emergency treatment and surgical intervention. With adequate postoperative care, blood replacement where necessary, appropriate medications, and regular follow-up, she is expected to recover fully. However, she remains at an increased risk of future ectopic pregnancies, pelvic adhesions, and reduced fertility, making early antenatal booking and ultrasound evaluation in subsequent pregnancies essential. Delayed treatment or failure to receive emergency surgery could have resulted in severe hemorrhagic shock and death.