The value of ultrasonography in the diagnosis of ectopic pregnancy at the Kenyatta National Hospital, Nairobi.
Over a six-month-period, from 1st March 1988 to 30th September 1988, 127 patients suspected of having ectopic gestation at the Kenyatta National Hospital (KNH) were referred for sonographic examination, of whom 100 (78.7%) had enough data for a final diagnosis. During sonography, ectopic pregnancy was diagnosed in 31 (31%) patients, out of whom 15 (48.4%) were confirmed to have ectopic gestation at laparotomy. Of the 69 who were thought to have other gynaecological disorders at sonographic examination, 2 (2.9%) were later found to have other ectopic gestation at surgery. Of the 17 patients who had ectopic gestation finally, extrauterine gestational sac with a demonstrable foetal pole were observed in only 6 (35.3%) cases, thus allowing a confident diagnosis of ectopic pregnancy by sonography. An empty, bulky uterus, demonstrable adnexal mass, pseudo-gestational sac and fluid in the culde-sac, together improved the sonographic positive predictive value to 67.0%. This study has shown that sonography can be used in the diagnosis of ectopic pregnancy at the KNH. However, in order to improve its reliability, further studies are recommended involving a combination of pregnancy test and sonography.
Dissanayake
L
L
Kenyatta National Hospital, Nairobi, Kenya.
Lema
V M
VM
Wanjala
S H
SH
Wachira
M W
MW
D000293:Adolescent; D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D015994:Incidence; D007630:Kenya / Q000453:epidemiology; D008875:Middle Aged; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016216:Ultrasonography, Prenatal / Q000295:instrumentation / Q000379:methods; D014505:Urban Population