Clinical pattern of gynaecological / early pregnancy complaints and 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 is ultrasound examination (USS).
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 Ilorin metropolis.
Method: Records of 253 consecutive cases with GEPC/LAC who had USS, using 3.5 and 5MHZ probes with SIEMENS Sonoline SL-1
machine, from January 2004 to December 2006 were retrieved and retrospectively analyzed for the following variables: Age, occupation,
complaints of vaginal bleeding with or without pains, history of amenorrhea or infertility ; clinical and ultrasound impressions of early
pregnancy complaints including ectopic pregnancies and pelvic inflammatory diseases (PID) with exclusion of uro-genital 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 yrs, and median= 29.00; Mode=25.00; STD of7.69973.The youngest patient was 15 yrs old while the oldest was
70yrs.Cases of bleeding per vaginam (PV) with or without pains were the highest, 149 cases (61.6%), followed by threatened abortion with 45
cases (18.6%) and non-viable or incomplete abortions with 13 cases (5.4%). In contrast dysfunctional uterine bleedings (DUB) ranked highest
among the USS results with 62 cases (25.6%); incomplete abortions cases were 44 (18.2%), while the non-viable pregnancies (missed abortions,
blighted ovum and early intra-uterine fetal deaths (IUFD) cases), contributed 26 cases (10.7%). Viable pregnancies were 9, Incomplete abortion 9, Dub 7, Non-viable pregnancies 6, Threatened abortions 4, P.I.D 4, complete abortion 2, query Infected or degenerating fibroid 2, Others 2. Threatened abortion ranked highest among the definite clinical diagnoses.
Conclusions: Bleeding per vaginam ranked highest among (GEPC/ LACS) in this environment while there is poor correlation between clinical
impressions and USS f indings.