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Clinical utility of serum reproductive hormones for the early diagnosis of ectopic pregnancy in the first trimester.
MedLine Citation:
PMID:  23148678     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
Chun Feng; Zheng-Yun Chen; Jing Zhang; Hong Xu; Xin-Mei Zhang; Xiu-Feng Huang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-14
Journal Detail:
Title:  The journal of obstetrics and gynaecology research     Volume:  -     ISSN:  1447-0756     ISO Abbreviation:  J. Obstet. Gynaecol. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9612761     Medline TA:  J Obstet Gynaecol Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.
Affiliation:
Department of Gynecology and Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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