title: Current approaches for assessment and treatment of women with early miscarriage or ectopic pregnancy in Nigeria: a case for dedicated early pregnancy services.
abstract: BACKGROUND
  It has been suggested that women with early miscarriage or ectopic pregnancy are best cared for in dedicated units which offer rapid and definitive ultrasonographic and biochemical assessment at the initial review of the patient.
  
  
  OBJECTIVE
  To describe the current protocols for the assessment and treatment of women with early miscarriage or ectopic pregnancy as reported by Nigerian Gynecologists, and determine if dedicated early pregnancy services such as Early Pregnancy Assessment Units could be introduced to improve care.
  
  
  METHODS
  A cross-sectional survey of Nigerian Gynecologists attending the 46 th Annual Scientific Conference of the Society of Gynaecology and Obstetrics of Nigeria.
  
  
  METHODS
  This was a questionnaire-based study.
  
  
  METHODS
  Data analysis was by descriptive statistics using Statistical Package for the Social Sciences software, version 17.0 for Windows (IBM Corporation, Armonk, NY, USA).
  
  
  RESULTS
  A total of 232 gynecologists working in 52 different secondary and tertiary health facilities participated in the survey. The mean age of the respondents was 42.6 ± 9.1 years (range 28-70 years). The proportion of gynecologists reporting that women with early miscarriage or ectopic pregnancy were first managed within the hospital general emergency room was 92%. The mean reported interval between arrival in hospital and first ultrasound scan was 4.9 ± 1.4 hours (range ½-8 hours). Transvaginal scan was stated as the routine initial imaging investigation by only 17.2% of respondents. Approximately 94.8% of respondents felt that dedicated early pregnancy services were feasible and should be introduced to improve the care of women with early miscarriage and ectopic pregnancy.
  
  
  CONCLUSIONS
  Reported protocols for managing early miscarriage or ectopic pregnancy in many health facilities in Nigeria appear to engender unnecessary delays and avoidable costs, and dedicated early pregnancy services could be both useful and feasible in addressing these shortcomings in the way women with such conditions are currently managed.
authors.affiliation: Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria.
authors.forename: C A
authors.initials: CA
authors.lastname: Iyoke
authors.forename: O G
authors.initials: OG
authors.lastname: Ugwu
authors.forename: F O
authors.initials: FO
authors.lastname: Ezugwu
authors.forename: H E
authors.initials: HE
authors.lastname: Onah
authors.forename: A T
authors.initials: AT
authors.lastname: Agbata
authors.forename: L C
authors.initials: LC
authors.lastname: Ajah
mesh_terms: D000022:Abortion, Spontaneous / Q000175:diagnosis* / Q000628:therapy*; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005260:Female; D006176:Gynecology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis* / Q000628:therapy*; D011295:Prenatal Care / Q000379:methods*; D011795:Surveys and Questionnaires; D016216:Ultrasonography, Prenatal