Is ectopic pregnancy too often diagnosed too late?
An increasing incidence of ectopic pregnancy resulted in 177 women being treated at National Womens's Hospital in 1979 and 1980. However, only 65% of women were diagnosed and treated within 24 hours of admission. The affected tube was conserved in only 24% of women. Blood transfusion was required in 52 patients (29%) and in one quarter of these cases, the diagnosis was not made within 24 hours of admission. Four of 20 patients who were discharged and readmitted before the diagnosis was made required blood transfusion, and one of these women was shocked. Women who present with pelvic pain and vaginal bleeding after less than 9 weeks amenorrhea and have pelvic tenderness and abdominal rebound tenderness, must be suspected of having an ectopic pregnancy. Early laparoscopy may then reduce the need for both transfusion and radical tubal surgery.
D000328:Adult; D001803:Blood Transfusion; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010146:Pain / Q000209:etiology; D010343:Patient Admission; D010359:Patient Readmission; D010388:Pelvis; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D012488:Salpingitis / Q000150:complications; D013997:Time Factors; D014592:Uterine Hemorrhage / Q000209:etiology