8852 Incidence and Risk Factors of Tubal Ruptured Ectopic Pregnancy: An Analysis Based on 10-Year Experience in Our Tertiary Medical Center

Abstract

<h3>Study Objective</h3> Determine predictors of tubal rupture in women with tubal ectopic pregnancy. <h3>Design</h3> Retrospective cohort study. <h3>Setting</h3> Tertiary university-affiliated hospital. <h3>Patients or Participants</h3> Patients admitted to our center with the diagnosis of tubal ectopic pregnancy between 2006 and 2016. <h3>Interventions</h3> Electronic medical records of all these patients were reviewed and analyzed. Data extraction included demographic, medical history, and laboratory results. The study aimed to assess risk factors and predictors for tubal rupture. Such as past obstetrical and surgical history, demographic characteristics, and serum β-hCG levels. <h3>Measurements and Main Results</h3> A total of 943 women were admitted in the above-mentioned period. Of those, 98 women had a clinical presentation of ruptured tubal pregnancy that was later confirmed by surgery. A comparison was made between the rupture group and 844 women with unruptured tubal pregnancy. Of 943 tubal pregnancies, 10.3% were ruptured. There was no difference in age, gravidity, admission gestational age, admission mean β-hCG levels, and history of previous ectopic pregnancies. There was a statistically significant difference between ruptured and unruptured groups in parity (1.1 vs. 0.81 respectively, P = 0.009) and live children rate (1.09 vs. 0.76, p=0.002). Tubal rupture occurred in any β-hCG level with the lowest level of 179 mIU/ml. although mean β-hCG levels did not differ between groups, we found that β-hCG level above 5000 mIU/ml was significantly higher in the rupture group. (21% vs. 10%, p=0.01) No significant difference was found when comparing tubal pregnancy risk factors such as a history of pelvic infection, IVF pregnancy, smoking, use of IUD or emergency contraceptive, past abdominopelvic surgeries, and endometriosis. <h3>Conclusion</h3> As seen in this large-scale study, women's parity, live children rate, and serum β-hCG levels >or=5,000 mIU/ml may help predict which tubal pregnancy will rupture. further investigation is needed to understand how this knowledge can be assimilated into the clinical decision-making process.