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Role of Ultrasonography in Diagnosis of Ectopic Pregnancy with Clinical Analysis and Management in Tertiary Care Hospital

机译:超声在三级医院诊断异位妊娠中的作用及临床分析与管理

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Purpose of the Study This study is undertaken to emphasize the role of ultrasonography in the diagnosis of ectopic pregnancy and clinical analysis of the same in a tertiary care referral hospital. Methodology One hundred patients with provisional diagnosis of ectopic pregnancy were studied. Physical examination, urine pregnancy test, transabdominal scan using 5?MHz transducer or transvaginal ultrasonography of 7?MHz was done. The diagnosis of ectopic pregnancy was confirmed by direct observation by laparotomy or laparoscopy (which was taken as gold standard). Results The study showed ectopic pregnancy was most common in gravida 2 and in age group 26–30?years with most of them having married life <10?years. One or more risk factors were found in 66?% of cases. 54?% of cases presented with acute symptoms, 14?% of cases in shock. Among clinical presentation pain abdomen, history of amenorrhea, bleeding per vaginum, abdominal tenderness, and cervical motion tenderness was most common. In ultrasonography, complex mass in adnexa was present in 60?% of cases and hemoperitoneum in 50?%. 96?% of cases were tubal pregnancy with most of them tubal rupture. In 98?% of cases, radical surgery was done. Salpingectomy was the most common surgery done (90?%). There was no negative laparotomy in this study. There was no maternal mortality in this series. Conclusions In all the 100 cases of ectopic pregnancy studied, the ultrasonography provided definitive diagnosis resulting in 100?% sensitivity and 100?% specificity, predictive value of positive test being 100?%. Ultrasonography done in earlier weeks of gestation had sensitivity of 96?% and false negative 4?%.
机译:研究目的本研究旨在强调超声检查在三级转诊医院对异位妊娠的诊断及其临床分析中的作用。方法学研究了一百例临时诊断为异位妊娠的患者。进行了体格检查,尿液妊娠试验,使用5?MHz换能器进行的腹部扫描或7?MHz的经阴道超声检查。异位妊娠的诊断通过腹腔镜或腹腔镜检查(金标准)直接观察得到证实。结果研究表明,异位妊娠在妊娠2和年龄在26-30岁的人群中最为普遍,其中大多数人的结婚年龄<10岁。在66%的病例中发现了一种或多种危险因素。出现急性症状的患者占54%,处于休克状态的患者占14%。在临床表现中,腹痛,闭经史,每个阴道出血,腹部压痛和颈椎运动压痛最为常见。在超声检查中,附件的复杂性占60%,而腹膜的占50%。 96%的病例为输卵管妊娠,其中大多数为输卵管破裂。在98%的病例中,进行了根治性手术。输卵管切除术是最常见的手术(90%)。在这项研究中没有阴性的剖腹手术。该系列没有产妇死亡率。结论在研究的所有100例异位妊娠病例中,超声检查均能提供明确的诊断结果,其敏感性为100%,特异性为100%,阳性试验的预测值为100%。妊娠早期几周进行的超声检查灵敏度为96%,假阴性为4%。

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