Tubal rupture in ectopic pregnancy: is it predictable?

AIM: 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.

CONCLUSION

In tubal ectopic pregnancy cases, hCG level on admission and size of ectopic pregnancy mass can predict tubal rupture.