The ability of traditional vital signs and shock index to identify ruptured ectopic pregnancy.
OBJECTIVE
This study evaluated the correlation between vital signs and hemoperitoneum and the association between abnormal vital signs and tubal rupture.


METHODS
With the use of a retrospective case-control design, the initial heart rate, systolic blood pressure, and heart rate/systolic blood pressure were correlated with respect to degree of hemoperitoneum; predictive values were calculated.


RESULTS
Fifty-two patients were studied (25 ruptured pregnancies and 27 unruptured ectopic pregnancies). Correlation coefficients were heart rate (r=0.50; 95% CI, 0.26-0.68), systolic blood pressure (r=-0.34; 95% CI, -0.56 to -0.08), and heart rate/systolic blood pressure (r=0.69; 95% CI, 0.51-0.81). The sensitivity for heart rate, systolic blood pressure, and heart rate/systolic blood pressure was 28%, 36%, and 72% respectively; the specificity was 96%, 96%, and 67%, respectively.


CONCLUSIONS
Normal vital signs alone are poor predictors of ruptured ectopic pregnancy; the heart rate/systolic blood pressure correlates best with the quantity of intraperitoneal hemorrhage.
Birkhahn
Robert H
RH
Department of Emergency Medicine, New York Methodist Hospital, Brooklyn, NY 11215, USA. rhbirkhahn@pol.net
Gaeta
Theodore J
TJ
Van Deusen
Shawn K
SK
Tloczkowski
John
J
D000328:Adult; D001794:Blood Pressure; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005187:Fallopian Tubes / Q000293:injuries*; D005260:Female; D006339:Heart Rate; D006465:Hemoperitoneum / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D012189:Retrospective Studies; D012421:Rupture / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D012680:Sensitivity and Specificity; D013599:Systole