[Minilaparotomy with a mini-pfannenstiel incision for the early diagnosis of ectopic pregnancy in Africa].
OBJECTIVE
to evaluate the usefulness of an exploratory minilaparotomy under local anaesthesia in cases of suspected ectopic pregnancy.


METHODS
Prospective study of the management of all cases of unruptured suspected ectopic pregnancy at the Gynaecological and Obstetrical Clinic at the Dakar University teaching hospital from 1 January, 2000, to 31 December, 2002.


RESULTS
44 unruptured ectopic pregnancies were recorded. The typical patient had no or few previous deliveries and was 30 years old; 27% of the patients presented risk factors for ectopic pregnancy. The principal motive for consultation was abnormal menstruation and pelvic pain; however, these symptoms together with a lateral uterine mass appeared in only 29.5% of the cases. Ultrasound examination was performed systematically and beta-HCG assessed for 36.8% of patients. The diagnostic was considered certain in 13.6% of the cases, probable in 36.3% and possible in 50%. Laparotomy was performed when the diagnosis was sure or probable, and an exploratory minilaparotomy was undertaken when the ectopic diagnosis was possible but uncertain. The diagnosis was confirmed in 79. 5% of the cases. The laparotomy failure rate was 18.7%, compared with 27.2% for the exploratory minilaparotomy, but the difference observed was not statistically significant (p=0.80).


CONCLUSIONS
In view of the equipment problems that make beta-HCG assays and laparoscopy difficult to perform in Africa, the minilaparotomy under local anaesthesia is a useful alternative.
Cissé
Cheikh Tdiane
CT
Clinique gynécologique et obstétricale, CHU de Dakar, BP 15 745, Fann, Dakar, Senegal. ctcissé@yahoo.fr
Belafia
El Badaoui
el B
Dieme
Marie-Edouard Faye
ME
Moreau
Jean-Charles
JC
D000328:Adult; D016009:Chi-Square Distribution; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D005260:Female; D006801:Humans; D007813:Laparotomy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D012675:Senegal / Q000453:epidemiology; D013997:Time Factors; D014463:Ultrasonography
D018997:Chorionic Gonadotropin, beta Subunit, Human