Correlation Between Vital Signs and Amount of Hemoperitoneum in Ruptured Ectopic Pregnancy

Abstract

IntroductionEctopic pregnancy is a life threatening emergency in first trimester of pregnancy. Hemodynamicstability of the patient remains one of the crucial factors that determine the treatment modalities.The main objective of this study was to study the correlation between the vital signs and amountof hemoperitoneum in ruptured ectopic pregnancy so that early and active interventions can bedone. MethodsWe conducted a cross sectional study of all the pregnant women with ruptured ectopic pregnancywith hemoperitoneum who presented to the emergency department of College of MedicalSciences Teaching Hospital from time period of 1st May 2017-31st May 2020.The different vitalsigns present at the time of initial emergency department and preoperative period prior surgerywere reviewed and used for correlation with amount of hemoperitoneum by using Pearsoncorrelation analysis. ResultsA total of 61 patients were studied. Pearson correlation between different vital signs and amountof hemoperitoneum were: heart rate(r=0.48, p<0.001), systolic blood pressure(r= -0.41,p=0.001),diastolic blood pressure (r= -0.34,p=0.06), mean arterial pressure (r= -0.37,p=0.03), respirationrate(r= 0.33, p=0.08) temperature (r=0.09,p=0.94), and shock index (r=0.55,p<0.001). Only 19 of 36patents with hemoperitoneum ≥750 ml had HR≥100 beats/min and 8 patients had SBP≤90mmHg. ConclusionsNone of the vital signs showed strong association with the amount of hemoperitoneum. Ifdecision for surgical interventions were made based on hemodynamic instability, most of thepatients would have been over-diagnosed and treated differently. Proper and timely diagnosiswith immediate management should be done.