title: [Minilaparotomy with a mini-pfannenstiel incision for the early diagnosis of ectopic pregnancy in Africa].
abstract: 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.
authors.affiliation: Clinique gynécologique et obstétricale, CHU de Dakar, BP 15 745, Fann, Dakar, Senegal. ctcissé@yahoo.fr
authors.forename: Cheikh Tdiane
authors.initials: CT
authors.lastname: Cissé
authors.forename: El Badaoui
authors.initials: el B
authors.lastname: Belafia
authors.forename: Marie-Edouard Faye
authors.initials: ME
authors.lastname: Dieme
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Moreau
mesh_terms: 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
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human