Laparoscopic surgery in patients with hypovolemic shock due to ectopic pregnancy.
OBJECTIVE
To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock.


METHODS
Two hundred and fifteen women with ectopic pregnancy underwent operative laparoscopy. These patients were divided into two groups. The study group included 21 patients with shock and intraperitoneal hemorrhage more than 1000 mL, and control group included 194 patients, hemodynamically stable, with blood loss less than 1000 mL. Clinical data of perioperative periods in two groups were retrospectively analyzed.


RESULTS
All patients were tubal pregnancies. The occurrence rate of tubal rupture was higher in study group than in control group (80.95% vs. 15.98%, P < 0.001). Intraabdominal blood loss was significantly higher in study group than in control group (1900 mL vs. 300 mL, P < 0.001), and autologous blood transfusions were given to 95.24% and 9.3% of patients in study and control group, respectively (P < 0.001). Laparoscopic salpingectomy was performed on 85.7 % and 50.5% of patients in study and control group (P < 0.001). The operative time was somewhat longer in study group than that in control group (60 minutes vs. 45 minutes), but with no significant difference. All patients had no perioperative complications.


CONCLUSIONS
Operative laparoscopy in patients with hopovolemic shock can be safely and effectively performed by experienced laparoscopists with the aid of optimal anesthesia, advanced cardiovascular monitoring, and autologous blood transfusion.
Li
Zhi-gang
ZG
Department of Obstetrics and Gynecology, Guangdong Provincial People's Hospital, Guangzhou 510080. muzigang0@163.net
Leng
Jin-hua
JH
Lang
Jing-he
JH
Liu
Zhu-feng
ZF
Sun
Da-wei
DW
Lan
Zhu
Z
D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D011274:Pregnancy, Tubal / Q000601:surgery; D012769:Shock / Q000209:etiology / Q000601:surgery*