Risk factors associated with the rupture of tubal ectopic pregnancy

Objective: To identify risk factors that may lead to the rupture of ectopic pregnancies. Study Design: A retrospective chart review was performed on patients with ectopic pregnancies at the University of Miami/Jackson Memorial Hospital between 1/1/1995 and 3/1/2002. 738 patients were identified with ectopic pregnancies. Women with tubal rupture were compared to those without rupture. Variables analyzed were demographic data, patient-related risk factors (history of pelvic surgery, bilateral tubal ligation, history of pelvic inflammatory disease, previous ectopic pregnancy, intrauterine device use) and β-human chorionic gonadotropin (βhCG) measurement. Results: There were 439 (59%) cases with a ruptured and 299 (41%) cases with an unruptured ectopic pregnancy. Multivariate logistic regression analysis revealed that previous ectopic pregnancy (OR 2.88; 95% CI 1.92,4.33) and βhCG level ≥5,000 mlU/ml (OR 1.85; 95% CI 1.12, 3.06) were the only significant risk factors for tubal rupture. Conclusion: Patients with βhCG levels ≥5,000 mlU/ml and patients with a history of a previous ectopic pregnancy are significantly more likely to experience a tubal rupture.