title: Optimising the diagnosis of ectopic pregnancy.
abstract: This retrospective cohort study reviewed the diagnosis of all ectopic pregnancies within a district general hospital over a 5-year period after the establishment of a dedicated Early Pregnancy Assessment Unit (EPAU). Of 215 ectopic pregnancies identified, notes were available for 208 (97%). Two-hundred and two cases were determined to have been diagnosed and managed as ectopic pregnancies. Six cases were excluded as they were pregnancies of unknown location managed as such. Overall, 91% were diagnosed by ultrasound scan, 5% were diagnosed clinically and 3% were diagnosed on serial human chorionic gonadotrophin (hCG) levels. This study found that the introduction of a dedicated, multi-professional, EPAU with a stable workforce improved ultrasound visualisation of ectopic pregnancies at first ultrasound scan from 22% prior to its commencement, to 61% over this period. The improvement in positive scan diagnosis of ectopic pregnancy was associated with a reduction in negative laparoscopy rate from 13% to 6%.
authors.affiliation: a Department of Obstetrics and Gynaecology , Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust , Portsmouth , UK .
authors.forename: Janet
authors.initials: J
authors.lastname: Berry
authors.affiliation: b Department of Obstetrics and Gynaecology , Princess Anne Hospital, University Hospital Southampton NHS Foundation Trust , Southampton , UK .
authors.forename: Mark
authors.initials: M
authors.lastname: Davey
authors.affiliation: c Department of Obstetrics and Gynaecology , Worthing Hospital, Western Sussex Hospitals NHS Foundation Trust , Worthing , UK , and.
authors.forename: Mei-See
authors.initials: MS
authors.lastname: Hon
authors.affiliation: d Department of Obstetrics and Gynaecology , Hampshire Hospitals Foundation Trust , Winchester , UK.
authors.forename: Renée
authors.initials: R
authors.lastname: Behrens
mesh_terms: D000293:Adolescent; D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D011258:Pregnancy Tests / Q000379:methods / Q000706:statistics & numerical data*; D011271:Pregnancy, Ectopic / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human
keywords: Ectopic pregnancy; diagnosis; early pregnancy assessment unit; negative laparoscopy