The ability of traditional vital signs and shock index to identify ruptured ectopic pregnancy

Am J Obstet Gynecol. 2003 Nov;189(5):1293-6. doi: 10.1067/s0002-9378(03)00663-x.

Abstract

Objective: This study evaluated the correlation between vital signs and hemoperitoneum and the association between abnormal vital signs and tubal rupture.

Study design: With the use of a retrospective case-control design, the initial heart rate, systolic blood pressure, and heart rate/systolic blood pressure were correlated with respect to degree of hemoperitoneum; predictive values were calculated.

Results: Fifty-two patients were studied (25 ruptured pregnancies and 27 unruptured ectopic pregnancies). Correlation coefficients were heart rate (r=0.50; 95% CI, 0.26-0.68), systolic blood pressure (r=-0.34; 95% CI, -0.56 to -0.08), and heart rate/systolic blood pressure (r=0.69; 95% CI, 0.51-0.81). The sensitivity for heart rate, systolic blood pressure, and heart rate/systolic blood pressure was 28%, 36%, and 72% respectively; the specificity was 96%, 96%, and 67%, respectively.

Conclusion: Normal vital signs alone are poor predictors of ruptured ectopic pregnancy; the heart rate/systolic blood pressure correlates best with the quantity of intraperitoneal hemorrhage.

MeSH terms

  • Adult
  • Blood Pressure*
  • Case-Control Studies
  • Diagnosis, Differential
  • Fallopian Tubes / injuries*
  • Female
  • Heart Rate*
  • Hemoperitoneum / diagnosis
  • Hemoperitoneum / etiology
  • Humans
  • Pregnancy
  • Pregnancy, Ectopic / complications*
  • Pregnancy, Ectopic / diagnosis*
  • Pregnancy, Ectopic / physiopathology
  • Retrospective Studies
  • Rupture / diagnosis
  • Rupture / etiology
  • Rupture / physiopathology
  • Sensitivity and Specificity
  • Systole