Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic review

Ectopic pregnancy (EP) is a common diagnosis, frequently misdiagnosed early in its presentation and a leading cause of first trimester mortality. Ultrasound (US) is a key component of evidence-based diagnostic algorithms. We present a systematic review on the frequency of the use of US in the diagno...

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Main Authors: Adrian H. Flores, Sherin Kassamali, Gloria Y. Won, John C. Stein, Teri Reynolds
Format: Article
Language:English
Published: Elsevier 2015-03-01
Series:African Journal of Emergency Medicine
Online Access:http://www.sciencedirect.com/science/article/pii/S2211419X14000792
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author Adrian H. Flores
Sherin Kassamali
Gloria Y. Won
John C. Stein
Teri Reynolds
author_facet Adrian H. Flores
Sherin Kassamali
Gloria Y. Won
John C. Stein
Teri Reynolds
author_sort Adrian H. Flores
collection DOAJ
description Ectopic pregnancy (EP) is a common diagnosis, frequently misdiagnosed early in its presentation and a leading cause of first trimester mortality. Ultrasound (US) is a key component of evidence-based diagnostic algorithms. We present a systematic review on the frequency of the use of US in the diagnosis of EP in Sub-Saharan Africa. Methods: A librarian-assisted search of PUBMED, EMBASE, Cochrane, Web of Science, and POPLINE databases was performed. Inclusion criteria were original research studies that reported the proportion of patients receiving US as part of a workup for EP in a Sub-Saharan African country. Abstracts were reviewed and those potentially meeting criteria had a formal survey of the manuscript. Results: The initial search revealed 784 original publications. Manual review of abstracts narrowed this to 91 papers with potential relevance, and 12 studies were included in the final analysis. A total of 6055 patients diagnosed with EP were included. 8.7% received a pregnancy test. 92.3% were ruptured at the time of presentation. 42.9% were in shock and 75.8% received red blood cell transfusion. 73.7% were unaware of the pregnancy and 24.9% were seen by a healthcare worker prior to presentation, 1.1% of patients died. Overall, 12.6% received US to aid in the diagnosis. Conclusion: In this study, overall utilisation of US in the diagnosis of EP was found to be low. In this population, patients presented late and critically ill, obviating the need for US in many cases. However, studies in Sub-Saharan Africa in populations of patients with similar rates of late presentations have shown a substantial increase in the diagnosis of unruptured EP with the routine use of US.
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spelling doaj.art-5a9db408e59847ecbf028b7bbfa9f0ac2022-12-22T01:50:09ZengElsevierAfrican Journal of Emergency Medicine2211-419X2015-03-0151313610.1016/j.afjem.2014.08.001Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic reviewAdrian H. Flores0Sherin Kassamali1Gloria Y. Won2John C. Stein3Teri Reynolds4University of California, San Francisco, San Francisco 94143, CA, USADepartment of Emergency Medicine, Muhimbili National Hospital, Dar es Salaam, TanzaniaH.M. Fishbon Memorial Library, UCSF Medical Center at Mount Zion, San Francisco 94143, CA, USAUniversity of California, San Francisco, San Francisco 94143, CA, USADepartment of Emergency Medicine, Muhimbili National Hospital, Dar es Salaam, TanzaniaEctopic pregnancy (EP) is a common diagnosis, frequently misdiagnosed early in its presentation and a leading cause of first trimester mortality. Ultrasound (US) is a key component of evidence-based diagnostic algorithms. We present a systematic review on the frequency of the use of US in the diagnosis of EP in Sub-Saharan Africa. Methods: A librarian-assisted search of PUBMED, EMBASE, Cochrane, Web of Science, and POPLINE databases was performed. Inclusion criteria were original research studies that reported the proportion of patients receiving US as part of a workup for EP in a Sub-Saharan African country. Abstracts were reviewed and those potentially meeting criteria had a formal survey of the manuscript. Results: The initial search revealed 784 original publications. Manual review of abstracts narrowed this to 91 papers with potential relevance, and 12 studies were included in the final analysis. A total of 6055 patients diagnosed with EP were included. 8.7% received a pregnancy test. 92.3% were ruptured at the time of presentation. 42.9% were in shock and 75.8% received red blood cell transfusion. 73.7% were unaware of the pregnancy and 24.9% were seen by a healthcare worker prior to presentation, 1.1% of patients died. Overall, 12.6% received US to aid in the diagnosis. Conclusion: In this study, overall utilisation of US in the diagnosis of EP was found to be low. In this population, patients presented late and critically ill, obviating the need for US in many cases. However, studies in Sub-Saharan Africa in populations of patients with similar rates of late presentations have shown a substantial increase in the diagnosis of unruptured EP with the routine use of US.http://www.sciencedirect.com/science/article/pii/S2211419X14000792
spellingShingle Adrian H. Flores
Sherin Kassamali
Gloria Y. Won
John C. Stein
Teri Reynolds
Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic review
African Journal of Emergency Medicine
title Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic review
title_full Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic review
title_fullStr Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic review
title_full_unstemmed Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic review
title_short Frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in Sub-Saharan Africa countries: A systematic review
title_sort frequency of utilisation of ultrasound in the diagnosis of ectopic pregnancy in sub saharan africa countries a systematic review
url http://www.sciencedirect.com/science/article/pii/S2211419X14000792
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