Clinical pattern of gynecological/early pregnancy complaints and the outcome of pelvic sonography in a private diagnostic center in Ilorin
AbstractBackground: Gynecological and early pregnancy complaints (GEPC)/lower abdominal complaints (LAC) are common in female patients seeking medical advice or treatments. Clinical limitations of GEPC or LAC are better resolved through appropriate laboratory and imaging investigation, among which the ultrasound examination (USS) is one.
Aim: To determine the distribution/clinical pattern of female patients with GEPC/LAC, and to evaluate the correlation between the clinical and sonographical diagnoses, as seen in a private diagnostic center in the Ilorin metropolis.
Materials and Methods: Records of 253 consecutive cases with GEPC/LAC, who had USS, were retrieved using 3.5 and 5 MHZ probes with SIEMENS Sonoline SL-1 machine, from January 2004 to December 2006, and retrospectively analyzed for the following variables: Age, occupation, complaints of vaginal bleeding, with or without pain, history of amenorrhea or infertility, clinical and ultrasound impression of early pregnancy complaints, including ectopic pregnancies and pelvic inflammatory diseases (PID), with exclusion of urogenital and gastrointestinal complaints/cases. Pregnancies greater than 12 weeks were excluded, bringing the total number of cases examined to 242.
Results: Mean age was 30.44 years, median = 29.00; Mode = 25.00; with an STD of 7.69973. The youngest patient was 15-years-old while the oldest was 70 years. Cases of bleeding per vaginam Bleeding per vaginam (BPV), with or without pain, were the highest, 149 cases (61.6%), followed by threatened abortion, 45 cases (18.6%), and non-viable or incomplete abortions, 13 cases (5.4%). In contrast dysfunctional uterine bleedings (DUB) ranked the highest among the USS results, with 62 cases (25.6%), incomplete abortion cases were 44 (18.2%), while the non-viable pregnancies (missed abortions, blighted ovum, and early intrauterine fetal deaths (IUFD) cases) contributed to 26 cases (10.7%). Viable pregnancies were nine; incomplete abortions, nine; DUB, seven; Non-viable pregnancies, six; Threatened abortions, four; PID, four; complete abortions, two; Query-infected or degenerating fibroids, two; and others two. Threatened abortion ranked the highest among the definite clinical diagnoses.
Conclusions: Bleeding per vaginam ranked the highest among GEPC/LACS in this environment, while there was poor correlation between clinical impressions and USS findings.