Shock index predicts ruptured ectopic pregnancy

From Reuters Health Information
Shock Index Predicts Ruptured Ectopic Pregnancy

By Robert Goodier
NEW YORK (Reuters Health) Sep 21 - A patient's shock index may help diagnose ruptured ectopicpregnancies and hemoperitoneum, a new study suggests.
The index -- heart rate divided by systolic blood pressure -- can significantly predict ruptured ectopic pregnancy if it is greater than 0.89,according to Dr. Roya Faraji and her team at Guilan University of Medical Sciences, in Rasht, Iran.
Ectopic pregnancy might be assumed, however, in pregnant patients who are in shock, an expert notassociated with the study says.
"It's proving what we already know, that they have bleeding in their belly and they need to go to the OR," Dr. Mona Orady, gynecologist at the Henry Ford Health System inDetroit, Mich., who was not involved in this research, told Reuters Health. "It would be interesting to know how many of them are in shock who don't have ectopic pregnancy."
Dr. Faraji's teampresented the results at the Society of Laparoendoscopic Surgeons 20th annual meeting in Los Angeles, Sept. 14-17.
They studied 99 cases of ectopic pregnancy, including 38 with rupture. They calculated amean shock index of 0.99 in ruptured cases and 0.82 when there wasn't rupture (P=0.001).
For an index cutoff of 0.89, the correlation with hemoperitoneum was significant (P=.001; r=.54).
An unrelatedstudy reported this past April in the European Journal of Emergency Medicine argues that while the shock index should raise suspicion when it is abnormal, it is too blunt to screen for disease.
ButDr. Faraji's group isn't the first to say the shock index could help diagnose a ruptured ectopic pregnancy. Published studies from Turkey, the U.S., and Nigeria have reported similar findings.
In 2006,the authors of the Nigerian paper wrote in the Journal of Obstetrics and Gynecology that the "shock index has a high predictive value in the Nigerian population studied and is a useful addition to...