ORIGINAL ARTICLE
Abstract

Objective: To define the validity of clinical predictive model for diagnosis of ectopic pregnancy using bedside USS (presence of haemoperitoneum) as a diagnostic aid.
Study Design: Prospective study
Study Duration: From 1st Aug 2010 to 31st Jan 2011
Materials and Methods: The Study was carried out at Department of Obstetrics and Gynaecology CMH Quetta. Diagnostic model including four parameters including one step Urine Pregnancy test (UPT), fluid in pouch of Dougles (POD) on ultrasound scan (USS), tachycardia and pelvic tenderness was assessed for predictive value in cases of suspected ectopic pregnancy. Sensitivity, Specificity, Positive (PPV) and Negative predictive values (NPV) for each parameter was calculated using ectopic pregnancy confirmed on surgical intervention as ‘gold standard’.
Results: The sensitivity and specificity of one step BHCG urine pregnancy test was 100%. The sensitivity of Fluid in POD on USS alone for diagnosis of ruptured ectopic pregnancy was 89% and the specificity was 50 %. The PPV for the test was 85 %, with NPV 60%. The sensitivity of tachycardia was 75% with specificity of 40% while PPV was 83 % and the NPV was 28%. The sensitivity of pelvic pain was 70% and specificity was 50% while PPV was 75 % and the NPV was 44%.
Conclusion: Predictive model using Fluid in pouch of Dougles on USS with positive one step UPT has a high sensitivity to diagnose leaking/ ectopic pregnancy. It is a non- invasive diagnostic measure that provides valuable information and can thus expedite patient care in suspected ectopic pregnancies.
Key Words:  Ectopic pregnancy , Trans Vaginal Sonography , Emergency Medicine Laparoscopy , Methotrexate

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