Circulating levels of placental protein 14 in ectopic pregnancy

Abstract

Objective To determine circulating levels of placental protein 14 (PP14) in complications of early pregnancy. Design Biochemical monitoring of women presenting with vaginal bleeding and/or abdominal pain. Setting An emergency gynaecological ultrasound clinic in a London teaching hospital. Subjects Venous blood samples were obtained from 67 women with normal pregnancy (n= 9), ectopic pregnancy (n= 26) and failed intrauterine pregnancy (n= 32). This group included anembryonic pregnancy (n= 18), missed miscarriage (n= 2), spontaneous miscarriage of a previously demonstrated live fetus (n= 6), incomplete miscarriage (n= 4), complete miscarriage (n= 1) and molar pregnancy (n= 1). Main outcome measures Serum PP14 levels in the group of women with a failed intrauterine pregnancy in relation to the normal range for PP14. Results Eighty‐one percent of women who miscarried spontaneously had normal serum PP14 levels; 81% of women with ectopic pregnancy had depressed (< 5th centile) serum PP14 levels. Conclusion Measurements of PP14 may be useful in distinguishing spontaneous miscarriage from ectopic pregnancy, but not in the management of threatened miscarriage.

Serum biomarkers of tubal ectopic pregnancy: current candidates and future possibilities

“…This was confirmed in a larger cohort of women with a tubal ectopic pregnancy (nZ59; Ruge et al 1992). A comparison of serum PAEP concentrations in women with spontaneous abortion (nZ32) and ectopic pregnancy (nZ26) found that 81% of women with spontaneous abortion had PAEP serum concentration levels within the normal range while 81% of women diagnosed with an ectopic pregnancy had PAEP levels below the fifth percentile of the normal range (Stabile et al 1994). In addition, the lower concentrations of serum glycodelin in ectopic pregnancy was not dependent on tubal status as this difference was maintained in patients with an unruptured tube, a ruptured tube or a tubal miscarriage (Foth & Romer 2003).…”

Serum levels of human placental lactogen, pregnancy‐associated plasma protein A and endometrial secretory protein PP14 in first trimester of diabetic pregnancy

“…The endometrial protein PP14 plays no known role during normal pregnancy (11), but it has been shown that PP14 levels are subnormal in ectopic pregnancy, perhaps as a result from nidation taking place in the tubal mucosa rather than in the endometrium (12). By (somewhat remote) analogy it might have been expected that PP14 levels in diabetic mothers with vascular disease (White's classes D and F) would differ from those in mothers without, but that was not the case.…”

Measurement of Intrauterine Human Decidua-Associated Protein 200 and Diagnosis of Ectopic Pregnancy

“…Only levels of placental protein 14 [5] and active renin [8] were significantly different comparing ectopic pregnancies and early missed abortions, although no discriminating cut-off level could be determined. Other biochemical markers were not discriminative in the diagnosis of ectopic pregnancy versus early missed abortion, although most of them (excluding creatine kinase) [10][11][12] could differentiate between ectopic and normal intrauterine pregnancy [6][7][8].…”

“…So far, different biochemical markers have been tested for their clinical value in the diagnosis of ectopic versus early intrauterine pregnancy: placental protein 14 [5], prorenin [8], active renin [8], intact hCG [7], free ßhCG [7], progesterone [6,7] and creatine kinase [9][10][11][12]. Only levels of placental protein 14 [5] and active renin [8] were significantly different comparing ectopic pregnancies and early missed abortions, although no discriminating cut-off level could be determined.…”

“…Therefore, several investigators have looked for biochemical tests to improve the diagnosis of ectopic pregnancy. Various pregnancy-associated proteins [4,5], progesterone [6,7], renin [8], free ßhCG [7] and creatine kinase [9][10][11][12] have been investigated, but none have been sufficiently sensitive and specific to be of clinical value.…”