Early recourse to laparoscopy in the management of suspected ectopic pregnancy. Accuracy and morbidity.
Ninety-nine patients with suspected ectopic pregnancy (EP) who were subjected to laparoscopy/laparotomy over an 18-month period at Greenwich District Hospital, London, were audited. A third (32/99) of the cases had an EP, and 67 potentially avoidable laparoscopies were performed. A potentially avoidable laparoscopy was followed by a laparotomy in 27% of cases (18/67), and at least 13 of those laparotomies were unnecessary. In addition, two false-positive diagnoses of EP were made at laparoscopy, resulting in the avoidable loss of part or all of a single remaining fallopian tube. With the use of sensitive pregnancy testing at least 62 laparoscopies, 13 laparotomies and 1 case of pulmonary embolus might have been avoided in these patients and up to 195 days' hospitalization saved.
Kadar
N
N
Department of Obstetrics and Gynaecology, King's College Hospital, London, England.
D005260:Female; D006767:Hospitals, District; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D007813:Laparotomy / Q000009:adverse effects / Q000592:standards* / Q000706:statistics & numerical data; D007902:Length of Stay; D008131:London; D008485:Medical Audit; D010043:Outcome and Process Assessment, Health Care; D010818:Practice Patterns, Physicians' / Q000592:standards*; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D012680:Sensitivity and Specificity