DIFFICULTIES AND ERRORS IN THE PREHOSPITAL DIAGNOSIS OF ECTOPIC PREGNANCY

The problem in the prehospital diagnosis of ectopic pregnancy (EP) in women is due to a significant frequency of errors and, as a consequence, delayed hospitalization for surgical treatment. Reducing diagnostic errors mainly in the prehospital stage can improve the quality of care for patients with EP. Objective. To analyze the errors of prehospital EP diagnosis and to optimize the latter. Subjects and methods. The quality of medical care was retrospectively analyzed in 194 patients with EP. By taking into account the identified defects, the authors elaborated an optimized approach to providing outpatient care for patients with EP and evaluated its efficiency in 332patients with suspected EP. Results. Unavailability of β-human chorionic gonadotropin (β-hCG) test results at the first visit is a main defect in medical care for patients with EP at the prehospital stage. The laboratory diagnosis of pregnancy, which complies with established standards and is based on serum β-hCG determination, does not meet the requirements for emergency outpatient care since it does not ensure the availability of the result at the same visit. The optimized approach increases the diagnosis of EP from 27.1 to 76.1% at the first visit. Conclusion. The correct diagnosis made on the day of a patient visit is a significant reserve to reduce severe and complicated cases.

ectopic pregnancy, rapid test for β-hCG, outpatient care