ABSTRACT
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
Subject(s)
Pregnancy, Ectopic/diagnosis , Ultrasonography , Utilization ReviewABSTRACT
RESUMEIl s'agit d'une etude retrospective realisee dans le service de Medecine Physique et de Readaptation du CHU de Yopougon faisant le bilan comparatif de deux annees d'activites (du 1er Janvier 2001 au 31 Decembre 2002). L'objectif etait de mettre en evidence l'influence du nouveau cadre de travail sur les activites du service afin de contribuer a l'amelioration de la prise en charge des patients en reeducation. Nous avons analyse les caracteristiques epidemiologiques; cliniques et socioprofessionnelles portant sur 1640 dossiers de patients recus en reeducation. Il ressort de cette etude que: *les sujets de sexe masculin predominaient (sex ratio de 1;5). *les affections de l'appareil locomoteur predominaient chez l'adulte (66;49pour cent) et chez l'enfant (53;40pour cent). *les pathologies chirurgicales predominaient chez l'adulte (58;03pour cent) et chez l'enfant (50;35pour cent). *la prise en charge en reeducation se faisait apres une therapeutique initiale (80;79pour cent). *la plupart des patients admis en reeducation (70;78pour cent) avaient beneficie d'une prescription de seance de reeducation. *69;07pour cent des patients ont correctement suivi leur reeducation. *le fort taux d'abandon (30;93pour cent) etait lie aux difficultes financieres et aux problemes socio-professionnels causes par le handicap. *l'efficacite de la reeducation sur toutes les pathologies est reelle (87;05 pour cent) avec une reprise professionnelle sans amenagement ni changement de poste de travail (76pour cent). *la reeducation interesse d'avantage le personnel medical de part les origines diverses des demandes de soins de reeducation. Les differentes pathologies et leurs prises en charge ont tres peu variees d'une annee a l'autre car le nouveau service de MPR reste encore non valorise