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Clinical utility of serum reproductive hormones for the early diagnosis of ectopic pregnancy in the first trimester
Author(s) -
Feng Chun,
Chen ZhengYun,
Zhang Jing,
Xu Hong,
Zhang XinMei,
Huang XiuFeng
Publication year - 2013
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/j.1447-0756.2012.02001.x
Subject(s) - medicine , human chorionic gonadotropin , pregnancy , luteinizing hormone , follicle stimulating hormone , gonadotropin , hormone , ectopic pregnancy , prolactin , testosterone (patch) , endocrinology , gynecology , biology , genetics
Aim: A tubal ectopic pregnancy (EP) in the first trimester remains a major life‐threatening complication for the mother. We aim to determine whether serum reproductive hormones may be clinically useful in the early identification of a tubal EP. Methods: A total of 109 age‐matched patients with a serum β‐human chorionic gonadotropin (β‐hCG) concentration <2000 IU/L were enrolled, including 68 patients with a tubal EP, 22 with a viable intrauterine pregnancy (vIUP) and 19 with a non‐viable intrauterine pregnancy (nIUP). Serum was collected during the first trimester of pregnancy and assayed for β‐hCG, follicle‐stimulating hormone (FSH), luteinizing hormone (LH), testosterone (TE), progesterone (P), estradiol (E 2 ) and prolactin (PRL) by using automated electrochemiluminescence immunoassays. Results: Patients with an EP had significantly lower levels of daily β‐hCG variation (Δβ‐hCG/day), P and E 2 , and significantly higher levels of LH and FSH than IUP patients ( P < 0.05). As an EP diagnostic marker, progesterone demonstrated a sensitivity of 100% at the cutoff of 86.01 nmol/L. The combination of E 2 with Δβ‐hCG/day reached a specificity of 100% for EP evaluation. To identify non‐viable pregnancies (including EPs and nIUPs), progesterone demonstrated a sensitivity of 95.40% and a specificity of 90.91% at the cutoff of 63.2 nmol/L; the diagnostic power of the receiver operating curve was 0.9702. Conclusions: A combination of Δβ‐hCG/day, P and E 2 may help distinguish EPs and nIUPs from vIUPs, facilitating earlier diagnosis and the timely implementation of medical treatment to prevent tubal rupture.