title: Is laparoscopic surgery safe in patients with an elevated shock index due to ruptured ectopic pregnancy?
abstract: OBJECTIVE
  To evaluate the effectiveness of laparoscopic surgery in patients with elevated shock index (SI), which is a unique determinant of acute hemorrhage.
  
  
  METHODS
  A retrospective chart review of all patients treated for ectopic pregnancy (EP) in the present gynaecology department between January 2007 and March 2011 was performed. For each measurement of heart rate (HR) and systolic blood pressure (SBP), a SI was calculated by dividing HR by SBP (normal, 0.5 - 0.7).
  
  
  RESULTS
  One hundred sixty patients were selected as SI above 0.7. There were 111 (69.4%) patients in the laparotomy group and 49 (30.6%) patients in the laparoscopy group. The postoperative hemoglobin (Hb) level was 8.46 +/- 1.56 (g/dl) in the laparotomy group and 9.37 +/- 1.52 (g/dl) in the laparoscopy group, with lower postoperative levels in the laparotomy group. The mean duration of postoperative hospital stay was 2.37 +/- 0.74 days in the laparotomy group and 2 +/- 0.84 days in the laparoscopy group.
  
  
  CONCLUSIONS
  The availability of suitable operative equipment, nursing teams, and advanced laparoscopic skills, all justify operative laparoscopy for the surgical treatment of EP in women with elevated SI.
authors.affiliation: Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Cengiz
authors.forename: C
authors.initials: C
authors.lastname: Kaya
authors.forename: M
authors.initials: M
authors.lastname: Ekin
authors.forename: S
authors.initials: S
authors.lastname: Karakaş
authors.forename: L
authors.initials: L
authors.lastname: Yasar
mesh_terms: D000328:Adult; D005260:Female; D006465:Hemoperitoneum / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000601:surgery*; D014463:Ultrasonography