Gynaecology Research Today is a free monthly online journal that collates and summarizes the latest research about Gynaecology, including details on pap smears, laparoscopy, ultrasound, hysteroscopy.

Ultrasound assessment of haemoperitoneum in ectopic pregnancy: derivation of a prediction model.

Fauconnier A, Mabrouk A, Salomon LJ, Bernard JP, Ville Y

ABSTRACT: BACKGROUND: To derive an ultrasound-based prediction model for the quantification of haemoperitoneum in ectopic pregnancy (EP). METHODS: Retrospective study of 89 patients operated upon EP between January 1999 and March 2003 in a French Gynaecology and Obstetrics department in a university hospital. Transvaginal sonograms, clinical and biological variables from patients with haemoperitoneum [greater than or equal to] 300 ml at surgery were compared with those from patients with haemoperitoneum < 300 ml or no haemoperitoneum. Sensitivity, specificity, positive and negative likelihood ratios were calculated for each parameter after appropriate dichotomization. Multiple logistic regression analysis was used to select the best combination at predicting haemoperitoneum [greater than or equal to] 300 ml. RESULTS: Three parameters predicted haemoperitoneum [greater than or equal to] 300ml independently: moderate to severe spontaneous pelvic pain, fluid above the uterine fundus or around the ovary at transvaginal ultrasound, and serum haemoglobin concentration < 10 g/dL. A woman with none of these three criteria would have a probability of 5.3 % for haemoperitoneum [greater than or equal to] 300 ml. When two or more criterias were present, the probability for haemoperitoneum [greater than or equal to] 300 ml reached 92.6 %. CONCLUSION: The proposed model accurately predicted significant haemoperitoneum in patients diagnosed to have EP.

Published 10 September 2007 in World J Emerg Surg, 2(1): 23.
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