Failure of standard criteria to diagnose nonemergency ectopic pregnancies in a noninfertility patient population

Michael P. Diamond, Mindy Wiser-Estin, Ervin E. Jones, Alan H. DeCherney

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Algorithms for the diagnosis of ectopic pregnancy are applied independent of the patient population. However, patients may require care at various times of gestation or for different reasons. To examine the utility of the same diagnostic criteria for identifying an ectopic pregnancy in different patient populations, we evaluated women from the infertility clinic and the residents' gynecology clinc at Yale-New Haven Hospital. Sixty women with nonemergency ectopic pregnancies were identified, 38 from the infertility clinic and 22 from the residents' clinic. Although the most common symptoms were the same in both groups (abdominal pain, spotting/bleeding >3 days, dizziness, shoulder pain), they were significantly more frequent in women from the residents' clinic. Despite care by the same attending physicians, ruptured ectopic pregnancies were more than 3 times as likely to occur in the noninfertility patients, and half as likely to be treated laparoscopically (p<0.01). Patients from the residents' clinic also were more likely to have postoperative complications(p<0.05), and had over a threefold higher risk of receiving a blood transfusion. We conclude that criteria for diagnosis and intervention in ectopic pregnancy may have to be modified on the basis of characteristics of the patient population.

Original languageEnglish (US)
Pages (from-to)131-134
Number of pages4
JournalAmerican Association of Gynecologic Laparoscopists
Volume1
Issue number2
DOIs
StatePublished - Feb 1994
Externally publishedYes

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ASJC Scopus subject areas

  • Obstetrics and Gynecology

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