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Hemoperitoneum assessment in ectopic pregnancy
Author(s) -
Popowski Thomas,
Huchon Cyrille,
ToretLabeeuw Flavy,
Chantry Anne A.,
Aegerter Philippe,
Fauconnier Arnaud
Publication year - 2012
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.09.019
Subject(s) - medicine , hemoperitoneum , ectopic pregnancy , confidence interval , odds ratio , obstetrics , laparotomy , focused assessment with sonography for trauma , radiology , pregnancy , abdominal trauma , blunt , biology , genetics
Abstract Objective To identify routine clinical, ultrasound, and biologic criteria to assess the volume of hemoperitoneum in women with ectopic pregnancy (EP). Methods Except for patients with hemodynamic shock, all women assigned to surgical laparoscopic treatment for confirmed EP at Poissy Saint Germain en Laye Hospital between January 2004 and December 2007 were included in the study. The patients underwent abdominal and digital pelvic examination, and standardized ultrasonography. Ordered logistic regression analysis was performed to select criteria associated with an increase in hemoperitoneum. The diagnostic accuracy of each variable was then calculated for different hemoperitoneum cut‐off values. Results The study included 215 patients. Pelvic pain of 4 or above on a numeric rating scale (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.3–4.1), abdominal guarding or rebound tenderness (OR, 4.6; 95% CI, 2.0–10.8), hemoglobin under 10 g/dL (OR, 12.2; 95% CI, 4.2–35.8), presence of fluid at transvaginal ultrasound (OR, 3.6; 95% CI, 1.4–9.2), and fluid in Morison pouch at abdominal ultrasound (OR, 5.6; 95% CI, 2.0–15.9) were found to be independently associated with hemoperitoneum. Conclusion Both clinical examination and standardized ultrasonography were found to be useful for accurate evaluation of hemoperitoneum in patients presenting with EP.