[Investigation of the amount of blood loss in patients with ruptured and unruptured ectopic pregnancies: a 3-year comparative study].
BACKGROUND
Anesthesiologists should carefully monitor clinical symptoms and hemodynamics of ectopic pregnant patients.


METHODS
We retrospectively investigated the backgrounds, vital signs, and amount of blood loss during surgery of ectopic pregnant patients who visited our hospital between July 2009 and June 2012.


RESULTS
Ultrasonic examinations revealed a ruptured ectopic pregnancy (REP) in 17 patients and unruptured ectopic pregnancy (UEP) in 19 patients. All operations were uneventful. One UEP patient became hemodynamically unstable immediately after arriving at the operating room because of a sudden rupture. The differences in patients' ages, heights, weights, gestational ages, and human chorionic gonadotropin levels were not statistically significant between the REP and UEP groups. Clinical symptoms (abdominal pain or atypical genital bleeding) were observed in 14 of 17 REP patients and in 5 of 19 UEP patients (relative risk 3.1, odds ratio 13.1). The amount of blood loss was 79 g in the UEP patients, 356 g in the 14 hemodynamically stable REP patients, and 1,762 g in the 3 hemodaynamically unstable REP patients. The clinical symptoms were related to the existence of ruptures.


CONCLUSIONS
It is important to monitor clinical symptoms in addition to hemodynamics for sudden hemodynamic changes in ectopic pregnancy.
Dan
D
Okura
Koji
K
Murashima
Kenji
K
Kayashima
D000328:Adult; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D000818:Animals; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data*; D004630:Emergencies; D005260:Female; D005831:Genital Diseases, Female / Q000503:physiopathology / Q000601:surgery; D013509:Gynecologic Surgical Procedures; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic; D010057:Oviducts; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D013997:Time Factors