Publications (2)5.02 Total impact
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Article: The diagnostic effectiveness of an initial transvaginal scan in detecting ectopic pregnancy.
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ABSTRACT: To determine the effectiveness of an initial transvaginal ultrasound scan (TVS) in the detection of ectopic pregnancy in consecutive women attending an early pregnancy unit (EPU). This was a prospective observational study. Unselected women attending a dedicated EPU underwent a TVS. Women were classified as having an intrauterine pregnancy (IUP), ectopic pregnancy or pregnancy of unknown location (PUL). Women with a PUL were followed up until the final location of the pregnancy was determined. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) with 95% confidence intervals (CIs) for the initial TVS in the diagnosis of ectopic pregnancy were calculated. During a one-year study period, 5318 consecutive women attended the EPU. Outcome data were available for 5240 (98.5%) women. Of these, the initial TVS showed an IUP in 4693 (89.6%) cases and an ectopic pregnancy in 91 (1.7%) cases. The remaining 456 (8.7%) women were classified as PUL, and of these 31 (6.8%) were subsequently found to have ectopic pregnancies. The overall sensitivity of the initial TVS in the diagnosis of ectopic pregnancy was 73.9% (95% CI: 65.1-81.6) with a specificity of 99.9% (95% CI: 99.8-100), a PPV of 96.7% (95% CI: 90.7-99.3) and an NPV of 99.4% (95% CI: 99.2-99.6). In unselected women attending an EPU, pregnancy location can be diagnosed accurately in over 90% of all pregnancies and in 73.9% of ectopic pregnancies with a single TVS.Human Reproduction 12/2007; 22(11):2824-8. · 4.47 Impact Factor -
Article: The outcome of pregnancy after large loop excision of the transformation zone of the cervix.
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ABSTRACT: A retrospective case control study to assess the outcome of pregnancy after large loop excision of the transformation zone of cervix (LLETZ) was carried out. One hundred and nineteen women who had undergone LLETZ and delivered in Basildon District Hospital were identified between January 1995 and December 1998; 119 age- and parity-matched controls were selected. Variables included were miscarriages, preterm deliveries, gestation at delivery, onset of labour, length of labour, augmentation of labour, mode of delivery and birth weight. The miscarriage rate in the study and control group were 11.8% and 9.2%, respectively (P=0.53). The preterm delivery rate in the study and control group were 10.9% and 9.2%, respectively (P=0.67). There were fewer caesarean sections and more spontaneous vaginal deliveries in the study group. There were slightly more instrumental deliveries in the study group. From this study, it was concluded that LLETZ does not appear to have an adverse effect on the outcome of pregnancy.Journal of Obstetrics and Gynaecology 02/2004; 24(1):25-7. · 0.54 Impact Factor
