title: [Ectopic pregnancy rupture--can it be prevented?].
abstract: OBJECTIVE
  To determine risk factors for ectopic pregnancy (EP) rupture based on the patients history and preoperative tests.
  
  
  METHODS
  The retrospective study consisted of 175 women operated on due to EP in the Department of Gynecology and Oncology of the Jagiellonian University between 2000-2008. Tubal rupture was diagnosed at the time of surgery. The patients were then divided into three groups: those who had unruptured EP without bleeding, those who had unruptured EP with hemorrhage into peritoneal cavity and those who suffered ruptured tubal pregnancy Analysis was performed based on the following parameters: patient history preoperative laboratory tests (Hb, Hct, betaHCG), and ultrasound exam.
  
  
  RESULTS
  Of the 175 cases of ectopic pregnancy included in the study 20% were unruptured without bleeding (A) and 40.6% unruptured with hemorrhage (B) while 39.4% were ruptured (C). There was a positive correlation between the diameter of the tubal lesion measured ultrasonographically and rupture (37.4 +/- 16 for C vs 29.7 +/- 12.9 for A; p=0.04). The gestational age of the groups differed significantly (p=0,001): C (56 +/- 1), A (49 +/- 3), and B (42 +/- 2). There was also a positive correlation between rupture and gravidity (1 +/- 1 for A vs 2 +/- 2 for C; p=0.02). Moreover a positive correlation of borderline significance was discerned between rupture and parity (p=0.06). Additionally the preoperative hemoglobin and hematocrit values were significantly lower in the rupture group (p=0.001). There was no significant difference among the three groups in age, number of abortions, serum betaHCG, endometrial thickness, length of hospital stay or the time elapsed since the most recent pregnancy.
  
  
  CONCLUSIONS
  Low hemoglobin and hematocrit values, together with higher gravidity at the time of admission, may indicate an increased risk of tubal rupture.
authors: Klinika Ginekologii i Onkologii Uniwersytetu Jagiellońskiego w Krakowie.
authors: Anna
authors: A
authors: Knafel
authors: Paweł
authors: P
authors: Basta
authors: Krzysztof
authors: K
authors: Skotniczny
authors: Mach
authors: M
authors: Paweł
authors: Bereza
authors: B
authors: Krzysztof
authors: Wojciech
authors: W
authors: Rokita
authors: Bogdan
authors: B
authors: Obrzut
authors: Łukasz
authors: Ł
authors: Wicherek
mesh_terms: D000328:Adult; D000367:Age Factors; D006063:Chorionic Gonadotropin / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008423:Maternal Age; D011044:Poland; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000097:blood / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery*; D012016:Reference Values; D012189:Retrospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000473:pathology / Q000517:prevention & control / Q000601:surgery; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin; D006454:Hemoglobins