Can noninvasive diagnostic tools predict tubal rupture or active bleeding in patients with tubal pregnancy?

Ben W.J. Mol*, Petra J. Hajenius, Simone Engelsbel, Willem M. Ankum, Fulco Van Der Veen, Douwe J. Hemrika, Patrick M.M. Bossuyt

*Corresponding author for this work

Research output: Contribution to journalArticle

41 Citations (Scopus)

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 languageEnglish
Pages (from-to)167-173
Number of pages7
JournalFertility and Sterility
Volume71
Issue number1
DOIs
Publication statusPublished - 1 Jan 1999

Keywords

  • Ectopic pregnancy
  • Noninvasive diagnosis
  • Tubal rupture

Fingerprint Dive into the research topics of 'Can noninvasive diagnostic tools predict tubal rupture or active bleeding in patients with tubal pregnancy?'. Together they form a unique fingerprint.

  • Cite this

    Mol, B. W. J., Hajenius, P. J., Engelsbel, S., Ankum, W. M., Van Der Veen, F., Hemrika, D. J., & Bossuyt, P. M. M. (1999). Can noninvasive diagnostic tools predict tubal rupture or active bleeding in patients with tubal pregnancy? Fertility and Sterility, 71(1), 167-173. https://doi.org/10.1016/S0015-0282(98)00418-X