Correlation between vital signs and hemoperitoneum in ruptured ectopic pregnancy

Authors

  • Nabil Mathlouthi
  • IKbal Ghodbane
  • Olfa Slimani
  • Riadh Ben Temime Service de gynécologie hôpital Charles Nicolle Tunis
  • Tahar Makhlouf
  • Leila Attia
  • Abdellatif Chechia

Keywords:

Ectopic pregnancy, tubal rupture, vital signs, Heart rate, Blood pressure, Hemoperitonieum.

Abstract

Background: Ectopic pregnancy (EP) is a medical-surgical emergency. Rupture of an ectopic pregnancy is a serious complication and may develop severe life-threatening to the patient.
Aim: To determine correlation between vital signs and hemoperitoneum in ruptured ectopic pregnancy and the association between abnormal vital signs and tubal rupture.
Methods: Via a retrospective study we have considered a sample of 32 patients of ruptured ectopic pregnancy. All patients were diagnosed at the Gynecology and Obstetrics Unit Aat Charles Nicole Hospital, Tunisia.
Results: Mean minimum systolic (SBP) 109 mmHg (range 70-150), mean maximum (HR) 81.5 beats/min (range 70-140). Mean volume of hemoperitoneum 693.75 mL (range 100 -2000 mL).Correlation between vital signs and volume of hemoperitoneum was poor (R 2 = 0.279 for HR, R 2= 0.267 for SBP). Hypotension was associated with blood loss of at least 1280 ml. Association of tachycardia with hypotension was observed in only 2 cases.Correlation between HR and SBP was not significant and poor (p=0.23, R 2= 0.05)
Conclusion: Normal vital signs alone are poor predictors of ruptured ectopic pregnancy and do not correlate well with volumes of hemoperitonieum.

Downloads

Download data is not yet available.

References

Coste J, Bouyer J, Job-spira N. Construction of composite scales for risk assesment in epidemiology: an application to ectopic pregnancy. Am J Epidemiol 1997; 145: 278-89.

Kaplan BC, Dart RG, Moskos M, et al. Ectopic pregnancy: prospective study with improved diagnostic accuracy. Ann Emerg Med 1996;28: 10-7.

Lehner R, Kucera E, Jirecek S, Egarter C, Husslein P. Ectopic pregnancy. Arch Gynecol Obstet 2000;263:87-92.

Snyder HS. Lack of a tachycardic response to hypotension with ruptured ectopic pregnancy. Am J Emerg Med 1990; 8:23-6.

Vayer JS, Henderson JV, Bellamy RF, Galper AR. Absence of a tachycardic response to shock in penetrating intra peritoneal injury. Ann Emerg Med 1988;17:227-31.

Cobb TL. Orthostatic tachycardia and ectopic pregnancy: Normal pulse rate in the presence of massive hemorrhage (letter). Ann Emer Med 1982;11:589-90.

Demetriades D, Chan LS, Bhasin P, et al. Relative bradycardia in patients with traumatic hypotension. J Trauma. 1998;45:534-9.

Oberg B, Thoren P: Increased activity in vagal cardiac afferents Correlated to the appearance of reflex bradycardia during severe hemorrhage. Acta Physiol Scand. 1970;80:22-3.

Hick JL, Rodgerson J D, Heegaard William G, Sterner S. Vital Signs Fail to Correlate With Hemoperitoneum From Ruptured Ectopic Pregnancy. Am J Emerg Med 2001;19:488-91.

Stovall TG, Kellerman AL, Ling FW, Buster JE. Emergency department diagnosis of ectopic pregnancy. Ann Emerg Med 1990; 19: 1098-103.

Mol BW, Hajenius PJ, Engelsbel S, et al. Can non invasive diagnostic tools predict tubal rupture or active bleeding in patients with tubal pregnancy? Fertil Steril 1999; 71: 167-73.

Hirata AJ, Soper DE, Bump RC, Hurt WG. Ectopic pregnancy in an urban teaching hospital: can tubal rupture be predicted? South Med J 1991; 84: 1467-9.

Fauconnier A, Mabrouk A, Heitz D, Ville Y. Grossesse extrautérine : intérêt et valeur de l'examen clinique dans la stratégie de prise en charge, J Gynecol Obstet Biol Reprod 2003; 32 : 18-27.

Downloads

Published

2012-11-23

Issue

Section

Original articles