Gynecological emergency ultrasound in daytime and at night: differences that cannot be ignored

Ther Clin Risk Manag. 2018 Jun 20:14:1141-1147. doi: 10.2147/TCRM.S169165. eCollection 2018.

Abstract

Background: Ultrasonography, the preferred adjunct examination method and the differential diagnostic tool for gynecologic emergency, can reflect the change pattern of gynecological diseases in daytime and at night. The purpose of this study was to analyze the diseases through gynecological emergency ultrasound in daytime and at night and to evaluate the day-night difference in the accuracy of ultrasound diagnosis.

Materials and methods: Retrospective analysis was performed on the 2016 clinical data of the patients who had undergone gynecological emergency ultrasound at The First Affiliated Hospital of Guangxi Medical University, and the results of the ultrasound diagnosis were compared with the clinical diagnosis.

Results: The following categories of gynecologic emergency diseases during the daytime and at night have significant statistical differences in the constituent ratio (P<0.001); ectopic pregnancy, intrauterine pregnancy, acute pelvic inflammatory disease, no organic lesion in uterine and adnexa; while the constituent ratio of abortion and trophoblastic diseases, ovarian tumor, uterine and endometrial lesions, was no statistical difference during the daytime and at night (P>0.05). The overall coincidence rate of ultrasound diagnosis was 96.3% (daytime, 97.9%; night, 86.4%). The coincidence rates of ectopic pregnancy ultrasonography diagnosis in daytime and at night were 96.4 and 75.4%, respectively; the difference was statistically significant (P<0.001).

Conclusion: Since the different constituent ratio of disease between daytime and night gynecological emergency ultrasound was significantly different, and the diagnostic accuracy of ultrasound at night was low; hence, the ultrasound doctor at night should pay attention to improve the accuracy of diagnosis and the ability of differential diagnosis of ectopic pregnancy, and it is suggested that some suspected cases during the night should be reexamined again in the daytime to eliminate the errors resulted from subjective factors.

Keywords: daytime; difference; emergency; gynecology; night; ultrasound.