Non-invasive management of patients with suspected ectopic pregnancy: a survey among Dutch gynaecologists

Objective: To investigate if implementation of a non-invasive diagnostic wo rk up of patients with suspected ectopic pregnancy, involving transvaginal sonography and serum human chorionic gonadotrophin (hCG) measurement decrea ses the likelihood of performing diagnostic laparoscopies. Study Design: We interviewed 27 Dutch gynaecologists using 16 structured case summaries in a fractional factorial design. Each case summary concerned a hypothetical p atient with suspected ectopic pregnancy. For each case presentation, the gy naecologists were asked for their inclination to perform laparoscopy. Resul ts: There were substantial differences in the degree to which data from a n oninvasive work-up influenced the decision to perform a laparoscopy. Some g ynaecologists would perform laparoscopy in all 16 patients at the first vis it, whereas others would initially admit none of them. Conclusion: Dutch gy naecologists seem to be familiar with a non-invasive diagnostic approach in women with suspected ectopic pregnancy. However, there are considerable di fferences in management approach probably due to individual variability in weighing the risks and benefits of expectant management. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.