Clinical characteristics of ectopic pregnancy in plateau area

Zhao Jing; Nimazhuoga; Li Lin

doi:10.3760/j.issn.1673-4777.2026.02.013

Abstract：Objective To investigate the clinical characteristics of ectopic pregnancy in plateau area.Methods A total of 283 patients with ectopic pregnancy admitted to Department of Gynecology,Lhasa People's Hospital,Tibet Autonomous Region from December 2021 to December 2024 were retrospectively selected,including 192 cases of tubal pregnancy,7 cases of cornual pregnancy,11 cases of uterine scar pregnancy,5 cases of ovarian pregnancy,and 68 cases of unspecified location.The clinical data of the patients were retrospectively analyzed.Results The average age of 283 patients was(31±6)years old,of which219 patients(77.4％)were Tibetan,66 patients(23.3％)were from areas with altitude≥4 000 m,121 patients(42.8％)had a history of abortion,101 patients(35.7％)had a history of pelvic surgery,27 patients(9.5％)had a history of ectopic pregnancy,and 26 patients(9.2％)with intrauterine device placement.A total of 203 cases of 283 patients were treated with laparoscopic or open surgery,including 43 cases(21.2％)with rupture and hemorrhagic shock symptoms,which were included in the combined shock group,including 35 cases(81.4％)of Tibetan patients,11 cases(25.6％)from altitude≥4 000 m,and the remaining 160 cases were included in the non combined shock group.There were no significant differences in age,pregnancy,parity,number of miscarriages,history of ectopic pregnancy,history of pelvic surgery,altitude≥4 000 m,and proportion of Tibetans between the two groups(all P>0.05).The intraoperative blood volume,blood loss,and total effusion volume in the combined shock group were greater than those in the non combined shock group,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower than those in the non combined shock group(all P<0.05).The bleeding volume of patients with ectopic pregnancy rupture hemorrhagic shock was 2 100(1 550,2 550)ml,and the preop-erative hemoglobin value of some patients was still within the normal range.Conclusion The occurrence of ectopic pregnancy complicated with hemorrhagic shock at high altitude has nothing to do with nationality,altitude of living area,number of miscarriages,ectopic pregnancy history or pelvic surgery history.The intraoperative blood volume,blood loss,and total effusion volume of the combined shock group were larger,and the preoperative and postoperative hemoglobin,red blood cell count,and hematocrit were lower.Due to the compensatory increase of hemoglobin in patients with hypoxia in plateau area,the hemoglobin value of patients with ectopic pregnancy in plateau area often cannot reflect the severity of the disease.It is necessary to pay attention to dynamic monitoring changes and make decisions as soon as possible combined with other examination methods.