A Correlation of Ultrasound and Surgical Findings in Suspected Ectopic Pregnancy at Kenyatta National Hospital

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This was a prospective descriptive study carried out at Kenyatta National Hospital from September 2008 to February 2009, whereby 73 patients who were diagnosed to have an ectopic pregnancy on the basis of ultrasound, later underwent laparotomy to confirm the diagnosis.

Objectives: The purpose of this study was to establish the accuracy of ultrasound, in the evaluation of a suspected ectopic pregnancy.

Methodology: Patients suspected to have an ectopic pregnancy on the basis of clinical assessment had an ultrasound examination using TAS and when TAS was inconclusive, TVS was used. The ultrasonograms were coded for: uterine size, intrauterine gestational sac, adnexal mass, adnexal ring, cul-de-sac fluid, or normal findings. Those who had ectopic pregnancy on the basis of ultrasonographic criteria were followed and ultrasound findings were compared with surgical findings in order to establish if ultrasound is a reliable method for diagnosis of ectopic pregnancy.

Results: 112 patients were assessed by ultrasound after clinical suspicion of ectopic pregnancy. 73 of them had ectopic pregnancy on the basis of ultrasound. Among these, 72 were confirmed on laparotomy to have an ectopic pregnancy, and 1 patient had a ruptured corpus luteum cyst. In this study, the most common site of ectopic  pregnancy was the fallopian tubes. Results confirmed on laparotomy showed that positive diagnoses by ultrasound were made in 98.6% of cases and false positive diagnosis in 1.4% of cases.

Conclusion: The results showed that pelvic ultrasound is a reliable method for diagnosis of ectopic pregnancy with a high sensitivity, specificity, positive and negative predictive value