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additional 11.6% of cases were converted to laparotomy for bleeding or other difficulties beyond the capability of the surgeon, or for hemodynamic instability. Only 1 of these cases was converted by a surgeon from the endoscopic unit. The remainder were planned laparotomies (patient collapsed or non-laparoscopic surgeon). Salpingectomy was the commonest procedure performed (80% of cases) while salpingostomy was carried out in 17.5% without any persistent trophoplastic problems. No intra-operative or post-operative major complications have been recorded. The median post-operative hospital stay was one day. Conclusion: Despite having a dedicated gynecological endoscopic unit, it has proved difficult to manage even 90% of ectopics laparoscopically. All but one of the conversions to laparotomy were by less experienced surgeons without the endoscopy unit, and if this conversion rate were dramatically reduced (without compromising patient safety), well over 95% of cases would avoid laparotomy. More effective training for surgeons and organization of the service is essential.

FC2.20.08 COMPARATIVE STUDY BETWEEN BHCG TEST (METHOD OF RIA) AND MONOCLONAL ANTIBODY TEST (BABY CHECK) IN PREDICTION OF ECTOPIC PREGNANCY (EP) P.Asadi (11 M.Pakgohar (2), SAlinaghi (3), (1) Azad University, P.O.Box: 16895-136, Daftar Omid, Tehranpars, Tehran, Iran, 16895, (2) Tehran University, Tehran, Iran, (3) Sepehr Behdasht Darou, Tehran, Iran.

Objectives: The aim of study was to investigate the worth Monoclonal Antibody test (Baby check) in prediction of Ectopic Pregnancy and compare with Beta HCG (RIA). Study Methods: 600 women with probable signs of EP in Gynecologic ward of three hospitals were invited to participate in this study.Two samples of blood were analyzed for Beta HCG and Monoclonal Antibody.Then they were followed in order to prove the EP diagnosisIt was proved in 60 of them. Results: Monoclonal Antibody test had a reliable predictive ability compared with Beta HCG (RIA). S ensitivity was 95% and Specificity was 99%. Conclusions: We conclude that Monoclonal Antibody test is a good replacement for Beta HCG in prediction of EP because of Sensitivity & Specificity & simplicity. It is cost-benefit and fast

FC2.20.09 ECTOPIC PREGNANCY -AN ANALYSIS OF 443 CASES 0. Kontic-Vucinic, G. Ivanovic, D. Ivanovic, P. Momcilov, B. Kastratovic, S. Petkovic, Institute of OB/GYN, Clinical Center of Serbia, 26 Visegradska, Belgrade, Serbia, Yugoslavia, 11000.

Objectives: In the aim of the study was to evaluate diagnostic procedures in ectopic pregnancy (EP). Study Methods: Case patients (n = 443)were women admited for EP during the 5 years period. Total incidences was 0.89% (8.9 per 1000 reported pregnancies). Bimanual examination, clinical symptoms and signs were indicative for EP in 44.5%. Ultrasound was performed in 74.3% cases and showed positive results in 74.5%. Measurement of serum _-hCG was used in 46.7% (detection limit 5 IU/L) we haven’t got false negative results. Results: Culdocentesis was performed in 52.4% cases and was diagnostic in 87.5%. Laparascopy was performed in only 8.4% patients and had 100% accurate results. Conclusions: Based on results of these study, a cutoff level of 1350 IU/L is recommended for patients with an ectopic mass or fluid in the pouch of Douglas; in patients without these findings, the cutoff level should be at least 2000 IU/L.

FC2.21 FETAL MONITORING

FC2.21.01 ANTENATAL ABDOMINAL FETAL ELECTROCARDIOGRAM RECORDING PRELIMINARY RESULTS OF A COMPACT AND PORTABLE MONITOR. C.J. Department of Obstetrics and Gynaecology, University Hospital, Nottingham, UK. J-F. Pieri, Department of Electrical and Electronic Engineering, University of Nottingham, UK. B.R. Hayes-Gill, Department of Electrical and Electronic Engineering, University of Nottingham, UK. J.A. Crowe, Department of Electrical and Electronic Engineering, University of Nottingham, UK. B.K. Strachan, Department of Obstetrics and Gynaecology, University Hospital, Nottingham, UK. D.K. James. Department of Obstetrics and Gynaecology, University Hospital, Nottingham, UK.

Objectives: The fetal electrocardiogram (FECG) is recorded from electrodes on the maternal abdominal surface but clinical use in the past has been restricted by small signal to noise ratios. We have developed a light portable monitor measuring 11.5cm x 14.5cm x 4cm. The objectives were to investigate the feasibility and success of using the monitor in the clinical setting. We present the preliminary data. Methods: Five minute recordings are taken from three channels. Our outcome measures are successful extraction of the FECG and percentage of the recording from which the RR interval can be extracted (% RR). The QRS peak to peak length was measured. Results: 301 recordings have been made from patients from 18 to 40 weeks’ gestation. The FECG was visible for at least part of the recording in 95% of the total number. An averaged QRS complex could be extracted in 80% of all recordings. The P wave was only reliably seen in 8% of all cases. The T wave was never seen. The computer extracted average %RR was 59.1%. There was no evidence of any effect of body mass index. We found a significant effect of electrode type on %RR when two were compared (MW p<O.O5). The QRS length increased with gestation and the effect of gestation on the %RR will be presented. Conclusion: The current FECG monitor extracts RR and QRS data extremely well. It is small, light and easy to use with the potential for antenatal FECG and fetal heart rate analysis.

FC2.21.02 FETAL VIBROACOUSTIC STIMULATION FOR FACILITATION OF TESTS OF FETAL WELLBEING K.H. Tan (l), R. Smyth (2) (20 Dept. Maternal Fetal Medicine, KK Hospital, Singapore (21 Cochrane Collaboration Pregnancy and Childbirth Group, Liverpool

Hospital, Liverpool, UK

Objective: To assess the merits or adverse effects of the use of fetal vibroacoustic stimulation (VAS) m conjunction with tests of fetal wellbeing. In particular, to assess whether the adjunctive use of VAS to alter fetal behavioral states leads to less false positive non-reactive tests. To assess whether the use of fetal VAS improves perinatal outcome, and is associated with costs savings and shorter testing time. Study Methods: This review drew on the search strategy developed for the Cochrane Pregnancy and Childbirth Group as a whole. All published and unpublished RCTs assessing the merits of the use of fetal VAS stimulation were identified in the Group’s Specialized Register of Controlled Trials. Systematic Review with meta-analysis was performed using the Cochrane software REVMAN 3. Results: 7 trials were included and 4 trials excluded based on the criteria. VAS reduced the incidence of non-reactive antenatal cardiotocography test (OR 0.61 CI 0.49 to 0.75) and reduced its testing time (-4.5 min CI -5.9 to 3.1 min). VAS evoked significantly more fetal movements than no stimulation when used in conjunction with fetal heart rate testing. Conclusions: VAS offers benefits by decreasing the incidence of non- reactive cardiotocography and reducing the testing time. Further RCTs should be encouraged to determine not only the optimum intensity, frequency, duration and position of the VAS, but also to evaluate the efficacy, predictive reliability, safety and perinatal outcome of these stimuli in conjunction with cardiotocography and also other tests of fetal wellbeing.