Non-invasive management of patients with suspected ectopic pregnancy: a survey among Dutch gynaecologists

Objective: To investigate if implementation of a non-invasive diagnostic work up of patients with suspected ectopic pregnancy, involving transvaginal sonography and serum human chorionic gonadotrophin (hCG) measurement decreases the likelihood of performing diagnostic laparoscopies. Study Design: We...

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Bibliographic Details
Published in:European journal of obstetrics & gynecology and reproductive biology 2001-03, Vol.95 (1), p.81-85
Main Authors: Engelsbel, Simone, Mol, Ben W.J, Hajenius, Petra J, Ankum, Willem M, van der Veen, Fulco, Hemrika, Douwe J, Bossuyt, Patrick M.M
Format: Article
Language:English
Subjects:
Biological and medical sciences
Chorionic Gonadotropin - blood
Data Collection
Diseases of mother, fetus and pregnancy
Ectopic pregnancy
Female
Gynecology
Gynecology. Andrology. Obstetrics
Humans
Implementation
Laparoscopy
Medical sciences
Netherlands
Non-invasive diagnosis
Pregnancy
Pregnancy, Ectopic - diagnosis
Pregnancy, Ectopic - diagnostic imaging
Pregnancy. Fetus. Placenta
Surveys and Questionnaires
Ultrasonography, Prenatal
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Summary:Objective: To investigate if implementation of a non-invasive diagnostic work up of patients with suspected ectopic pregnancy, involving transvaginal sonography and serum human chorionic gonadotrophin (hCG) measurement decreases the likelihood of performing diagnostic laparoscopies. Study Design: We interviewed 27 Dutch gynaecologists using 16 structured case summaries in a fractional factorial design. Each case summary concerned a hypothetical patient with suspected ectopic pregnancy. For each case presentation, the gynaecologists were asked for their inclination to perform laparoscopy. Results: There were substantial differences in the degree to which data from a non-invasive work-up influenced the decision to perform a laparoscopy. Some gynaecologists would perform laparoscopy in all 16 patients at the first visit, whereas others would initially admit none of them. Conclusion: Dutch gynaecologists seem to be familiar with a non-invasive diagnostic approach in women with suspected ectopic pregnancy. However, there are considerable differences in management approach probably due to individual variability in weighing the risks and benefits of expectant management.
ISSN:0301-2115
1872-7654
DOI:10.1016/S0301-2115(00)00369-9