Establishing symptoms scores for ectopic pregnancy

A French collaborative study has been published in the journal “Academic Emergency Medicine”. The authors set out to develop a symptom score to predict ectopic pregnancy rupture. The abstract can be read at: http://www.ncbi.nlm.nih.gov/pubmed/22221975

They examined a number of different pain variables. However the most significant were: vomiting during pain, diffuse abdominal pain, pain lasting more than 30 minutes and “flashing” pain. The presence of one or more of these pain features gave a detection rate for rupture of 93%, a 44% specificity and a negative likelihood ration of  0.16. What this means is that most ectopic pregnancies have one or more of these pain features – but they are not very specific – in other words other conditions will also give rise to these symptoms. The absence of any of these factors usually (although not exclusively) – means rupture has not happened yet.

The paper is of interest as there has been a call to try to better understand the symptoms associated with ectopic pregnancy rupture. This paper is not the last word and patients should always err on the side of caution – but starting to understand the symptoms of ectopic pregnancy will hopefully lead to more robust advice so that women can identify dangerous symptoms when they occur.

Professor Tom Bourne

Professor Tom Bourne is Adjunct Professor at Imperial College London, and Consultant Gynaecologist at Queen Charlotte's and Chelsea Hospital. He is also visiting Professor at KU Leuven, Belgium. He has extensive clinical and research experience in early pregnancy care as well as gynaecological ultrasound. He has published over 300 academic papers with an H-index of 63. He advises NICE, is trustee of the ectopic pregnancy trust, President of the UK association of early pregnancy units (AEPU) and on the board of ISUOG. He has a private practice at The Women's Ultrasound Centres at 86 Harley Street and Parkside Hospital in Wimbledon.

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About Professor Tom Bourne

Professor Tom Bourne is Adjunct Professor at Imperial College London, and Consultant Gynaecologist at Queen Charlotte's and Chelsea Hospital. He is also visiting Professor at KU Leuven, Belgium. He has extensive clinical and research experience in early pregnancy care as well as gynaecological ultrasound. He has published over 300 academic papers with an H-index of 63. He advises NICE, is trustee of the ectopic pregnancy trust, President of the UK association of early pregnancy units (AEPU) and on the board of ISUOG. He has a private practice at The Women's Ultrasound Centres at 86 Harley Street and Parkside Hospital in Wimbledon.
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