Criteria for Sonographic Investigations of Ectopic Pregnancies: A Study of Practice at a Tertiary Healthcare Facility in Kitwe, Zambia
Keywords:beta-hCG, clinical information, extra-uterine pregnancy, systems theory, ultrasonography
Background. Ectopic pregnancy (EP) occurs when a fertilised embryo implants extra-endometrium. Common symptoms include lower abdominal pain, amenorrhea, and per vaginal (PV) bleeding. Ultrasonography (sonography) plays a positive role in investigating EP.
Aim. The aim of this study was to establish the relationship between the clinicians’ provisional diagnosis for EP and the conclusion in the respective diagnostic ultrasound report.
Methods. A retrospective descriptive quantitative study was performed to examine 50 files of women aged 12 to 25 years with lower abdominal pain and a provisional diagnosis for EP. Statistical Package for Social Sciences version 22 (SPSS 22.0) of 2013 and Microsoft Excel 2010™ software facilitated data analysis, guided by the systems theory.
Results. Files reviewed for completeness of clinical information recorded EP signs or symptoms: lower abdominal pain, amenorrhea, pelvic mass, and PV bleeding. The positive laboratory test findings for pregnancy, based on human chorionic gonadotropin (HCG) hormone were also on record in some cases. The files were examined for expressed provisional diagnosis of EP by clinicians and supported by clinical history involving lower abdominal pain (98%), amenorrhea (78%), and PV bleeding (76%). Most files were silent on the question of palpable pelvic mass (90%) and laboratory pregnancy tests (74%), which could have reinforced the provisional diagnosis. The adequacy of clinical information for provisional diagnosis was categorised as adequate, fairly adequate, and inadequate. The sonography requisition forms (SRFs) depicted compliance to compelling clinical details for provisional diagnosis (88%) and reference to previous ultrasound examination (2%). The overall finding showed increased compatibility between provisional diagnosis and sonographic findings for EP in cases with adequately recorded information on clinical history.
Conclusion. This study established that adequate completion of SRFs by clinicians and provision of appropriate clinical information enhanced diagnosis of EP.
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