title: Tubal rupture in ectopic pregnancy: is it predictable?
abstract: OBJECTIVE
  Ectopic pregnancies account for 10-15% of all maternal deaths. Rupture of an ectopic pregnancy is an urgent medical situation, therefore prediction of any tubal rupture before its occurrence is extremely important. The aim of this study was to evaluate the tubal rupture rate in different treatment modalities in EP cases and to find a hCG level on admission and/or size of ectopic mass predictive for tubal rupture.
  
  
  METHODS
  Demographic data and medical data were extracted from patient charts for 211 cases who had diagnosis of tubal ectopic pregnancy. Women with tubal rupture were compared to those without rupture.
  
  
  RESULTS
  Expectant management, single dose methotrexate and primary surgical treatment were applied to 83 cases (39%), 93 cases (44%) and 35 cases (17%), respectively. The tubal rupture occurred in 14.7% of the study population. If the EP mass diameter is <2 cm, no tubal rupture was found. hCG values at admission were found to be predictive for rupture. On admission, hCG level of 1855 IU/L had 93.5%, sensitivity and 29% positive predictive value for tubal rupture.
  
  
  CONCLUSIONS
  In tubal ectopic pregnancy cases, hCG level on admission and size of ectopic pregnancy mass can predict tubal rupture.
authors: Department of Obstetrics and Gynecology Ministry of Health, Etlik Zübeyde Hanim Womens Health Research Hospital Ankara, Turkey - yytasci@yahoo.com.
authors: R S
authors: RS
authors: Karadeniz
authors: Y
authors: Y
authors: Tasci
authors: M
authors: M
authors: Altay
authors: M
authors: M
authors: Akkuş
authors: O
authors: O
authors: Akkurt
authors: O
authors: O
authors: Gelisen
mesh_terms: D000293:Adolescent; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011274:Pregnancy, Tubal / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D006063:Chorionic Gonadotropin; D008727:Methotrexate