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

Overview

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.