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.