THE VALUE OF ULTRASONOGRAPHY IN THE DIAGNOSIS OF ECTOPIC PREGNANCY ATTHE KENYATTA-NATIONAL-HOSPITAL, NAIROBI

Over a six-month-period, from 1st March 1988 to 30th September 1988, 1 27 patients suspected of having ectopic gestation at the Kenyatta Nati onal Hospital (KNH) were referred for sonographic examination, of whom 100 (78.7%) had enough data for a final diagnosis. During sonography, ectopic pregnancy was diagnosed in 31 (31%) patients, out of whom 15 (48.4%) were confirmed to have ectopic gestation at laparotomy. Of the 69 who were thought to have other gynaecological disorders at sonogra phic examination, 2 (2.9%) were later found to have other ectopic gest ation at surgery. Of the 17 patients who had ectopic gestation finally , extrauterine gestational sac with a demonstrable foetal pole were ob served in only 6 (35.3%) cases, thus allowing a confident diagnosis of ectopic pregnancy by sonography. An empty, bulky uterus, demonstrable adnexal mass, pseudo-gestational sac and fluid in the cul-de-sac, tog ether improved the sonographic positive predictive value to 67.0%. Thi s study has shown that sonography can be used in the diagnosis of ecto pic pregnancy at the KNH. However, in order to improve its reliability , further studies are recommended involving a combination of pregnancy test and sonography.