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A cohort of women with ectopic pregnancy: challenges in diagnosis and management in a rural hospital in a low-income country.
Mooij, R; Mgalega, G C; Mwampagatwa, I H; van Dillen, J; Stekelenburg, J.
Afiliación
  • Mooij R; Ndala Hospital, PO Box 15, Ndala, Tanzania. r.mooij1983@gmail.com.
  • Mgalega GC; VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands. r.mooij1983@gmail.com.
  • Mwampagatwa IH; Ndala Hospital, PO Box 15, Ndala, Tanzania.
  • van Dillen J; College of Health Sciences, University of Dodoma, PO Box 395, Dodoma, Tanzania.
  • Stekelenburg J; Radboud University Medical Centre, Geert Grooteplein-Zuid 10, 6525 GA, Nijmegen, The Netherlands.
BMC Pregnancy Childbirth ; 18(1): 159, 2018 May 11.
Article en En | MEDLINE | ID: mdl-29751791
ABSTRACT

BACKGROUND:

Ectopic pregnancy (EP) is a serious complication of early pregnancy. In low-income countries diagnosis of EP is difficult and it is a major contributor to maternal mortality. We aimed to assess and improve the diagnostic process of women with EP.

METHODS:

We conducted a retrospective medical records study of all women with confirmed EP in Ndala Hospital from 2010 to 2012. We used data on demographics, symptoms, diagnostic procedures, surgical findings, treatment and post-operative status.

RESULTS:

Six thousand six hundred sixty-two women gave birth in the hospital, and 88 women were diagnosed with EP (incidence 1.3%). Thirty-nine percent of women did not report to be pregnant or to have a history of amenorrhea. On admission in Ndala hospital, a diagnosis of 'suspected EP' was made in less than half (47%) of the cases. Most women had a urine pregnancy test done (sensitivity of 98%). Peritoneal aspiration was done in 42%. The fifty-five women with EP who were diagnosed by ultrasound received a lower mean number of units of blood transfusion and had less often severe anaemia than women who were diagnosed by abdominal aspiration (abdominocentesis). The majority of women (65%) had surgery within 24 h after admission.

CONCLUSIONS:

Diagnosing EP in a rural hospital in Tanzania is challenging. Often there is a large doctors' delay before the right diagnosis is made. Abdominal aspiration can be useful for rapid diagnosis. A pelvic ultrasound, when available, allows the diagnosis to be made earlier with less intra-abdominal bleeding.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embarazo Ectópico / Diagnóstico Prenatal / Aborto Inducido / Diagnóstico Tardío Tipo de estudio: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: Africa Idioma: En Revista: BMC Pregnancy Childbirth Asunto de la revista: OBSTETRICIA Año: 2018 Tipo del documento: Article País de afiliación: Tanzania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Embarazo Ectópico / Diagnóstico Prenatal / Aborto Inducido / Diagnóstico Tardío Tipo de estudio: Diagnostic_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: Africa Idioma: En Revista: BMC Pregnancy Childbirth Asunto de la revista: OBSTETRICIA Año: 2018 Tipo del documento: Article País de afiliación: Tanzania