Abstract
Objective: To evaluate the ability of noninvasive diagnostic tools to predict tubal rupture and active bleeding in patients with tubal pregnancy. Design: Prospective cohort study. Setting: Two large teaching hospitals in Amsterdam, The Netherlands. Patient(s): Consecutively seen patients with suspected tubal pregnancy who were scheduled to undergo confirmative laparoscopy. Main Outcome Measure(s): Tubal rupture and/or active bleeding confirmed at laparoscopy. Result(s): Sixty-five (23%) of 288 patients had tubal rupture and/or active bleeding at laparoscopy. Abdominal pain, rebound tenderness on abdominal examination, fluid in the pouch of Douglas at transvaginal ultrasound examination, and a low serum hemoglobin level were independent predictors of tubal rupture and/or active bleeding. Pregnancy achieved with the use of IVF-ET and the presence of an ectopic gestational sac or an ectopic mass at ultrasound examination reduced the risk of tubal rupture. Abdominal pain was the most sensitive predictor, with a sensitivity of 95%. Conclusion(s): Because the nonsurgical management of tubal pregnancy should be used only when the risk of tubal rupture and/or active bleeding is low, it can be safely applied in only a limited number of patients.
Original language | English |
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Pages (from-to) | 167-173 |
Number of pages | 7 |
Journal | Fertility and Sterility |
Volume | 71 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jan 1999 |
Externally published | Yes |
Keywords
- Ectopic pregnancy
- Noninvasive diagnosis
- Tubal rupture