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Title: The impact of the availability of ultrasonography in the acute gynaecology unit
Authors: Haider, Z ×
Condous, G
Khalid, A
Kirk, E
Mukri, F
Van Calster, Ben
Timmerman, Dirk
Bourne, Tom #
Issue Date: Aug-2006
Publisher: Blackwell Science
Series Title: Ultrasound in Obstetrics & Gynecology vol:28 issue:2 pages:207-213
Abstract: OBJECTIVE: The initial assessment of acute gynecology patients is usually based on history and clinical examination and does not involve ultrasound. The aim of this study was to investigate the impact of the availability of transvaginal sonography at the time of initial assessment of the emergency gynecology patient. METHODS: This was a prospective observational study carried out over a 5-month period in the acute gynecology unit of an inner London teaching hospital. Women were assessed in the routine manner by history-taking and clinical examination and questionnaires were completed by the doctors, including details of the intention to treat. Transvaginal ultrasound examinations were then performed and a second diagnosis and management plan were made utilizing the extra information from the scan. The plans for clinical management before and after the ultrasound examination were compared. RESULTS: We originally recruited 1000 consecutive women to the study. The mean age was 31.1 (SD, 9.81) years. Complete data were available for 920 (92%). 84 (9.1%) women did not require a scan. Of the 521 women with a positive pregnancy test, 75.6% were reassured immediately that their pregnancy was intrauterine. 143 women (27.4%) were given the diagnosis of a suspected ectopic pregnancy before sonography, compared with 29 (5.6%) after. Following the ultrasound examination there was a change in clinical management in 54.1% of the women with a positive pregnancy test and a reduction in admissions (including inpatient theater admissions) (from 40.3% to 17.1%) and outpatient follow-up examinations (from 41.1% to 35.5%). In 90 (23.8%) non-pregnant women a significant ovarian cyst (> 5 cm) was suspected clinically; 28/90 (31.1%) were confirmed on sonography. Following the ultrasound examination there was a change in clinical management for 38.1% of non-pregnant women and a reduction in admissions (from 37.1% to 19.4%) and outpatient follow-up examinations (from 25.7% to 18.1%). CONCLUSION: It appears that the availability of transvaginal sonography at the time of initial assessment of emergency gynecology patients improves diagnostic accuracy and reduces unnecessary admissions and follow-up examinations.
Description: \emph{Ultrasound in Obstetrics and Gynecology}, vol. 28, no. 2, Aug. 2006
URI: 
ISSN: 0960-7692
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Section Woman - Miscellaneous (-)
Basic Research in Gynaecology Section (-)
ESAT - STADIUS, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics
Screening, Diagnostics and Biomarkers (-)
× corresponding author
# (joint) last author

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