Showing Latest Articles
Indicators of potential for rupture for ectopics seen in the emergency department Full Text
Journal of Emergencies, Trauma and Shock, 08/17/2011
Downey LVA et al. - The result of the study did not find any single sign, symptom, or test that could reliably differentiate patients who have a ruptured ectopic from those who do not. However, b-hCG over 1500 mIU was the best variable in explaining the variation between those who would or would not go on to rupture after their emergency departments (ED) visit.
Methods- This study was a retrospective chart review of all women aged≥18 years during a 5-year period who were diagnosed with ectopic pregnancy to a level I ED.
- Data collected included basic demographic information, medical, surgical, obstetric and gynecologic history, social and sexual history, findings on physical examination, and laboratory values such as urine pregnancy test, b-hCG, and complete blood count.
- There was a significant difference using a multivariate regression analysis with 95% CI in history findings of abdominal pain, nausea, vomiting, and urinary tract symptoms.
- There was a significant difference in physical examination of pulse, diastolic pressure, abdominal tenderness, peritoneal signs, cervical motion tenderness, and adnexal tenderness.
- There was also a significant difference in b-hCG, hemoglobin and hematocrit results and ultrasound findings of free peritoneal fluid, intrauterine pregnancy and cardiac findings between those who ruptured and those who did not.
- None of these tests was able to differentiate those that would go on to rupture.