Risk factors associated with blood transfusion in ectopic pregnancy

OBJECTIVE: To determine the risk factors associated with blood transfusion in ectopic pregnancy. STUDY DESIGN: A retrospective chart review of the presentation and hospital course of ectopic pregnancies managed over five years at two hospitals was undertaken. Thirty-two variables, including demographics, presenting signs and symptoms, and intraoperative findings, were examined with univariate a nd multivariate logistic modeling. RESULTS: Among 185 patients with histologically confirmed ectopics who were managed surgically, 8.6% (16 women) required transfusion. Multivariate ana lysis of risk factors for blood transfusion demonstrated a statistically si gnificant association with (1) initial hemoglobin <10 g/dL (odds ratio [OR] 38.8, 95% confidence interval [CI] 6.0-356.8); (2) human chorionic gonadot ropin levels greater than or equal to 6,500 mIU (OX 18.1, 95% CI 3.6-158.1) ; and (3) abnormal bleeding on presentation (OX 0.08, 95% CI 0.007-0.42). T he presence of two of these factors had a sensitivity of 82% (95% CI 48-98% ) and a positive predictive value of 33% (95% CI 16-54%). No case had all t hree factors. CONCLUSION This study was, to our knowledge, the first regression analysis of risk factors for transfusion associated with ectopic pregnancy. It demon strated that initial hemoglobin and human chorionic gonadotropin levels as well as abnormal bleeding on presentation are independent risk factors for blood transfusion in ectopic pregnancy.