Giá trị mức dịch túi cùng Douglas trên siêu âm trong đánh giá lượng máu mất ở bệnh nhân thai ngoài tử cung phẫu thuật

Abstract

In the surgical management of ectopic pregnancy, accurate estimation of blood loss and prediction of transfusion requirement are essential for timely resource allocation and clinical decision making. In this retrospective descriptive study of 65 patients at Hau Giang Obstetrics and Pediatrics Hospital from January 2024 to March 2024, ultrasonographic pouch of Douglas fluid was evaluated for its value in blood loss stratification and prediction of transfusion requirement. The proportion of patients with blood loss greater than 500 mL was 36.9%. Median blood loss increased from 200 mL in patients without fluid to 1500 mL in those with a large amount of fluid (p < 0.001). The degree of fluid in the pouch of Douglas predicted blood loss greater than 500 mL and transfusion requirement with an area under the curve of 0.89 and 0.96, respectively. A large amount of fluid achieved 100% specificity for predicting severe hemorrhage. These findings indicate that the degree of fluid in the pouch of Douglas has high clinical value in risk stratification, supporting early activation of transfusion protocols and urgent surgical intervention.