OBSTETRICS AND GYNAECOLOGY / CLINICAL RESEARCH
Impact of emergency point-of-care ultrasound on time to diagnosis and treatment amongst patients with ectopic pregnancy: a systematic review and meta-analysis
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1
Department of Gynecology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
2
Emergency Department, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
3
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
Submission date: 2024-07-01
Final revision date: 2024-08-03
Acceptance date: 2024-08-21
Online publication date: 2024-09-06
Corresponding author
Xupeng Shao
Emergency Department,
Affiliated Hospital
of Shandong University
of Traditional Chinese
Medicine
No. 16369 Jingshi Road,
Jinan City, Shandong
Province, 250014, China
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Ectopic pregnancy, a significant cause of morbidity in women of reproductive age, requires timely diagnosis and treatment to reduce adverse outcomes. This study examines the impact of point-of-care ultrasound in the emergency department on the time to diagnosis, treatment, and surgical intervention for ectopic pregnancies.
Material and methods:
Our review encompassed studies involving patients with ectopic pregnancies who underwent point-of-care ultrasound in emergency settings. The comparator was standard radiology department ultrasound. We included studies of any design, and the key outcomes were time to diagnosis, treatment, and operating room. Data synthesis employed a random-effects inverse-variance model. The GRADE approach was used to assess evidence quality, and the PRISMA checklist guided our methodology.
Results:
Overall, four studies were included. For time to diagnosis, the pooled standardized mean difference (SMD) was –1.965, indicating a significant reduction. For time to treatment, the pooled SMD was –0.809, showing a modest effect with considerable heterogeneity (I² = 87.5%). In surgically treating ectopic pregnancies, the impact was not statistically significant overall, but was significant for the subgroup of ruptured ectopic pregnancies. The overall quality of evidence was deemed very low due to moderate risk of bias, high heterogeneity, and publication bias.
Conclusions:
Point-of-care ultrasound in emergency departments significantly reduced the time to diagnose ectopic pregnancies. The effect on time to treatment and operating room varied, with notable benefits observed in more severe cases. Despite these promising findings, the quality of evidence and high heterogeneity necessitate cautious interpretation and call for further research.
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