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| A report of 27 tubal pregnancy women with intraperitoneal hemorrhage and low serum HCG level |
| Beijing Haidian Hospital, Beijing,100080 |
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Abstract Objective: To explore the diagnosis and treatment of tubal pregnancy women with intraperitoneal hemorrhage. Methods：A retrospective analysis was conducted on 27 tubal pregnancy women with intraperitoneal hemorrhage and low serum HCG level（<1000mIU/ml）who experienced surgery in Beijing Haidian hospital. Results：The median value of serum HCG level of included women was 460.2mIU/ml. Surgery was the first choice for 74.1% (20/27) women, while 25.9%（7/27）women were transferred to surgery due to failure of MTX therapy. The feature of transvaginal sonography was the heterogeneous echopattern near to ovary. The median volume of bleeding in abdominal cavity was 800 ml. 70.4% tubal abortion and 25.9% tubal rupture was found during operation. The pain situation and the serum HCG level were related with volume of intraperitoneal bleeding. Literature review suggests that intraperitoneal bleeding of women with tubal pregnancy had complex clinical phenotype, there was no any single predictive factor could be used for predicting intraperitoneal bleeding occurred in women with tubal pregnancy. Conclusion: The tubal pregnancy women with Intraperitoneal hemorrhage may be have different clinical characteristic. The view of transvaginal sonography only used for predicting intraperitoneal bleeding because of tubal pregnancy rupture should be change, it is necessary to seek for clinical parameters which can be used for predicting intraperitoneal hemorrhage of women with tubal pregnancy.
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