The risk factors of rupture and abortion of tubal pregnancy——a retrospective study based on 2280 tubal pregnancy cases
Abstract 【Objective】The morbidity of ectopic pregnancy is about 1%~2%, and it accounts for about 10% of maternal death. Tubal rupture and tubal abortion can both lead to massive hemorrhage, but their risk factors are lack of study. Through studying the ectopic cases at the third affiliated hospital of Sun Yat-Sen University, the study aims to analyze the risk factors of tubal rupture and tubal abortion. 【Methods】To collect the ectopic pregnancy cases undergoing surgeries from the year 2011 to the year 2019 retrospectively, divide them into ruptured group, aborted group, and unruptured and unaborted group. T-test, Mann–Whitney–Wilcoxon test and Pearson’s chi-square, and Fisher’s exact test were applied for univariate analysis. Multivariate logistic regression analysis was used to identify the risk factors of tubal rupture and tubal abortion (variables with a P value < 0.1 by univariate analysis were entered into the multivariate analysis). 【Results】Abdominal pain(OR:3.101, 95%CI:1.812–5.306, P < 0.001), cervical lifting pain(OR:2.942, 95%CI:2.046–4.231, P < 0.001), the mass diameter ≥ 4cm(OR:2.874, 95%CI:2.095–3.941, P < 0.001), HCG ≥ 5000U/L(OR:2.588, 95%CI:1.900-3.526, P < 0.001), adnexal tenderness(OR:1.893, 95%CI:1.296–2.764, P = 0.001), age ≥ 35(OR:1.781, 95%CI:1.232–2.573, P = 0.002), aspirating blood during culdocentesis(OR:1.497, 95%CI:1.081–2.074, P = 0.015) are the risk factors of tubal rupture, while vaginal bleeding(OR:0.271, 95%CI:0.196–0.375, P < 0.001) is the protective factor of tubal rupture. HCG < 2000U/L (OR:3.554, 95%CI:2.401–5.260, P < 0.001) and mass diameter ≥ 4cm (OR:2.732, 95%CI:1.900-3.929, P < 0.001) are the risk factors of tubal abortion. 【Conclusions】When facing an ectopic pregnancy patient considering pelvic bleeding happens, if HCG ≥ 5000U/L, it’s more likely to be tubal rupture, if HCG < 2000U/L, it’s more likely to be tubal abortion.