Kanem Journal of Medical Sciences (Jan 2008)
VALUE OF ULTRASONOGRAHY IN THE DIAGNOSIS OF NON-PREGNANCY RELATED GYNAECOLOGICAL EMERGENCIES
Abstract
Background: Non-pregnancy related gynecological emergencies arc conditions that are life threatening. Accurate Diagnosis and early institution of appropriate management is the hallmark of good prognosis. Ultrasound scanning, a safe and non-invasive method of making early, and accurate diagnosis will be invaluable in the management of these women. Objective: To review the value of ultrasonography in the diagnosis of non-pregnancy related gynecological emergency. Method: All the patients referred with non-pregnancy related gynecological conditions from the gynecological emergency unit of Aminu Kano Teaching Hospital (AKTH), Kano. Nigeria, for emergency ultrasound scanning. Ultrasound findings/diagnosis was also noted, as well as the final diagnosis following clinical evaluation, laboratory tests, surgery, and/or histology. The association between the ultrasound diagnosis and the final diagnosis (accuracy of ultrasonography) was evaluated using tests of validity. Results: The total number gynecological emergencies that were scanned were 700 out of which 322 were non-pregnancy related condition giving an incidence of 46.0%. The highest number of patient 209 (64.9) was seen in the 21 to 35 years age group, which is the most active period in the females reproductive life. Acute pelvic inflammatory diseases (PID) was the commonest condition with 132 patients (41.0%), ovarian mass with 96 patients (29.8%), degenerative uterine fibroid with 62 patients (19.3) and dysfunctional uterine bleeding (DUB) with 31 paitenis(9.9%). The positive predictive value of ultrasound scanning for PID was 72.3%, for torsion of for ovarian cyst was 91.7%, for uterine fibroid 82.3%, and 87.1% for DUB. Conclusion: Test of validity showed a high and significant positive predictive value of ultrasound scanning for non pregnancy related gynaecological condition. This shows that ultrasound scan is a valuable tool in making early diagnoses and instituting appropriate management in women with these conditions. Our recommendation is that all centres that are offering gynaecological emergency services should make ultrasound scanning facilities available 24 hours of the day as well as trained manpower in order to improve their service
