Johan Fistouris: New methods for diagnosing ectopic pregnancy
Ectopic pregnancy is a serious condition where the pregnancy develops outside the uterus. The diagnosis is often difficult to establish during the initial examination. Johan Fistouris has studied new methods to improve diagnostic accuracy and explored how the evaluation process affects patients’ mental health.
JOHAN FISTOURIS
Dissertation defense: 17 January 2025 (click for details)
Doctoral thesis: Managment of Pregnancy of Unknown location. Diagnostic protocols, clinical outcomes and psychosocial aspects
Research area: Obstetrics and Gynecology
Sahlgrenska Academy, The Institute of Clinical Sciences
Women experiencing early pregnancy complications are a common group at gynecological emergency departments. Some of these women are at an increased risk of having an ectopic pregnancy.
It is often difficult to diagnose ectopic pregnancy during the first ultrasound examination. A delayed diagnosis can lead to severe abdominal bleeding, which may be life-threatening.
“In my thesis, I investigate different methods to diagnose ectopic pregnancy in high-risk patients and how the management of these patients can be improved in a gynecological emergency setting. The research also examines how the evaluation of suspected ectopic pregnancy affects women’s mental well-being and quality of life,” says Johan Fistouris, who is a physician specializing in IVF and reproductive medicine and a doctoral student at the Institute of Clinical Sciences.
Faster diagnosis with a new method
What do the studies reveal about these methods?
“One predictive model showed marginally better diagnostic accuracy than the method currently used at the gynecological emergency department at Sahlgrenska University Hospital. The two methods were compared in a randomized study, but no significant differences were found in clinical outcomes, such as bleeding and other complications related to ectopic pregnancy,” explains Johan Fistouris.
“Another predictive model showed significantly higher sensitivity in identifying women with ectopic pregnancy compared to the method currently in use. However, this model has not been evaluated in a clinical study. It could potentially shorten the time to treatment and thereby reduce the risk of complications.”
Psychological support for patients needed
The doctoral thesis also highlights that women undergoing evaluation for ectopic pregnancy often experience elevated levels of anxiety and depression, comparable to those reported by women who have experienced a miscarriage.
“This is new knowledge that underscores the urgent need for structured psychological support for these patients. The results emphasize the importance of integrating mental health care into the management of women being evaluated for suspected ectopic pregnancy.”
What have you found most rewarding and challenging about your doctoral project?
“The entire process, from formulating a research question to designing and conducting the study, to analyzing results that could hopefully make a difference in practice, has been incredibly rewarding. The greatest challenge has been patient recruitment.”
Text: Jakob Lundberg