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PLOS ONE  2014 

Successful Conservative Management of Ruptured Ovarian Cysts with Hemoperitoneum in Healthy Women

DOI: 10.1371/journal.pone.0091171

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Abstract:

Study Objective To determine the success rate of the “intended conservative management strategy” of ruptured ovarian cysts with hemoperitoneum and the risk factors for surgical interventions in healthy women of reproductive age. Methods Patients who visited the emergency department with abdominal pain and were diagnosed with a ruptured ovarian cyst with hemoperitoneum between August 2008 and June 2013 were included in this retrospective study. The diagnosis of the ruptured ovarian cysts and hemoperitoneum was based on the clinical symptoms, physical examination and ultrasound and CT imaging. The rate of surgical interventions and the risk factors for surgical intervention were determined. Results A total of 78 women were diagnosed with a ruptured ovarian cyst with hemoperitoneum. Most patients (80.8%, 63/78) were managed conservatively, and 19.2% of the patients (15/78) required a surgical intervention. In the multiple logistic regression analysis, the diastolic blood pressure (dBP) (odds ratio [OR] of 0.921 with 95% confidence interval [CI] of 0.855–0.993) and the depth of the total pelvic fluid collection in CT (DTFC_CT) (OR 1.599 with 95% CI 1.092–2.343) were the significant determining factors of surgical intervention after adjustment. The rate of surgical intervention was 6.5% vs. 15.8% vs. 77.8% in the patients with neither dBP≤70 mmHg nor DTFC_CT≥5.6 cm, those with only one of those features, and those with both, respectively. Conclusion Most cases of ruptured ovarian cysts with hemoperitoneum can be managed conservatively. A low diastolic blood pressure and a large amount of hemoperitoneum suggest the need for surgical intervention.

References

[1]  MacKenna A, Fabres C, Alam V, Morales V (2000) Clinical management of functional ovarian cysts: a prospective and randomized study. Hum Reprod 15: 2567–2569. doi: 10.1093/humrep/15.12.2567
[2]  Hertzberg BS, Kliewer MA, Paulson EK (1999) Ovarian cyst rupture causing hemoperitoneum: imaging features and the potential for misdiagnosis. Abdom Imaging 24: 304–308. doi: 10.1007/s002619900502
[3]  Ho WK, Wang YF, Wu HH, Tsai HD, Chen TH, et al. (2009) Ruptured corpus luteum with hemoperitoneum: case characteristics and demographic changes over time. Taiwan J Obstet Gynecol 48: 108–112. doi: 10.1016/s1028-4559(09)60267-9
[4]  Raziel A, Ron-El R, Pansky M, Arieli S, Bukovsky I, et al. (1993) Current management of ruptured corpus luteum. Eur J Obstet Gynecol Reprod Biol 50: 77–81. doi: 10.1016/0028-2243(93)90168-c
[5]  Bottomley C, Bourne T (2009) Diagnosis and management of ovarian cyst accidents. Best Pract Res Clin Obstet Gynaecol 23: 711–724. doi: 10.1016/j.bpobgyn.2009.02.001
[6]  Bydder GM, Kreel L (1980) Attenuation values of fluid collections within the abdomen. J Comput Assist Tomogr 4: 145–150. doi: 10.1097/00004728-198004000-00002
[7]  Taniguchi T, Kilkenny GS (1951) Rupture of corpus luteum with production of hemoperitoneum; report of nineteen cases. J Am Med Assoc 147: 1420–1424. doi: 10.1001/jama.1951.03670320020009
[8]  Adams SL, Greene JS (1986) Absence of a tachycardic response to intraperitoneal hemorrhage. J Emerg Med 4: 383–389. doi: 10.1016/0736-4679(86)90216-7
[9]  Jansen RP (1978) Relative bradycardia: a sign of acute intraperitoneal bleeding. Aust N Z J Obstet Gynaecol 18: 206–208. doi: 10.1111/j.1479-828x.1978.tb00051.x
[10]  Somers MP, Spears M, Maynard AS, Syverud SA (2004) Ruptured heterotopic pregnancy presenting with relative bradycardia in a woman not receiving reproductive assistance. Ann Emerg Med 43: 382–385. doi: 10.1016/j.annemergmed.2003.08.004
[11]  Thorson CM, Ryan ML, Van Haren RM, Pereira R, Olloqui J, et al. (2013) Change in hematocrit during trauma assessment predicts bleeding even with ongoing fluid resuscitation. Am Surg 79: 398–406.
[12]  Queenan JT, O’Brien GD, Bains LM, Simpson J, Collins WP, et al. (1980) Ultrasound scanning of ovaries to detect ovulation in women. Fertil Steril 34: 99–105.
[13]  Lucey BC, Varghese JC, Anderson SW, Soto JA (2007) Spontaneous hemoperitoneum: a bloody mess. Emerg Radiol 14: 65–75. doi: 10.1007/s10140-007-0594-0
[14]  Lucey BC, Varghese JC, Soto JA (2005) Spontaneous Hemoperitoneum: Causes and Significance. Current Problems in Diagnostic Radiology 34: 182–195. doi: 10.1067/j.cpradiol.2005.06.001
[15]  Choi NJ, Rha SE, Jung SE, Choi BG, Oh SN, et al. (2011) Ruptured endometrial cysts as a rare cause of acute pelvic pain: can we differentiate them from ruptured corpus luteal cysts on CT scan? J Comput Assist Tomogr 35: 454–458. doi: 10.1097/rct.0b013e31821f4bd2

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