Diagnostic significance of total creatine kinase and its isoform in tubal ectopic pregnancy

Abstract

Estimation of CK and its CK isoenzyme fractions can aid in quick and accurate diagnosis of tEP.

Biomarkers of Ectopic Pregnancy-Present and Future

“…Similar findings were observed by Birkhahn et al and Duncan et al [105,106]. In a study conducted in our population, we found that the optimal cut-off for total CK, CK-MM and CPK-MB% as predictors of ruptured EP were 147 IU/L, 135 IU/L and 10%, respectively, with the former two having higher specificity, and latter high sensitivity [107]. On the contrary, several independent study groups found CK to be inadequate in diagnosing EP [108][109][110][111][112].…”

Evaluation of Cesarean Section Scar Using Maternal Serum Level of Creatine Kinase Isoenzyme (Ck-Mb) Prior to Delivery

“…Interest has centered on the CKMB hybrid of myocardial origin [11,12] . The uterus and placenta, two organs which were reported to embody substantial amounts of these enzymes, and which participate actively in the process of labor, are thought to release these enzymes to the circulation during labor [13] , Therefore, prediction of uterine dehiscence prior to onset of labour by using CKMB as a soft marker may have clinical significance; A prospective study performed at Al-Zahraa University Hospital where ninety women were included in our study, sixty women with previous cesarean section with forty two with elective CS and eighteen with emergency CS, thirty with NVD in active labour ranged from 18-40 years, the gravidity ranged from 0-7. Estimated gestational age ranged from 36-40 wks, The interdelivery interval ranged from 12-48 months, The whole LUS thickness by 2D TAS ranged from (2.5-5.7 mm).…”

“…Turan and his coworkers measured CK levels to investigate if the locked method gave injury to the uterine muscle. The increase in the levels of CK in locked method was remarkable [15] , Researchers believe that serum CK can be a diagnostic marker of tubal ectopic pregnancy (tEP) , as the theory on which it is claimed that CK can be marker of tEP is that the tubal musculature lacks a submucosal layer and hence the penetrating trophoblastic tissue is expected to injure the tubal smooth muscle and release a sufficient amount of this enzyme into circulation [13] , Also serum CPK activity were reported significantly higher in women with tubal pregnancy that may or may not have ruptured and are reliable in the diagnosis of a tubal pregnancy. They observed significant elevation in CPK and CKMB serum activity in ectopic pregnancy [13] , Shao and Yang used creatine kinase (CK) in the diagnosis of scar uterus and placenta previa implantation, CK expression in the implantation group were,significantly higher than non-implantation group [16] , This is may be explained by Banu et al, who suggested that an increasing amount of serum creatine kinase (CK) isoenzymes would give an idea about the destruction of the myometrial tissue [17] .…”

Diagnostic Biomarkers for Predicting Adverse Early Pregnancy Outcomes

“…Biomarkers that have been examined in early pregnancy can be categorised according to their biological origin …”

“…Markers include creatine kinase (CK), an enzyme released following muscle damage; myoglobin; smooth muscle heavy chain myosin; and adrenomedullin (ADM), a peptide hormone thought to be involved in ciliary beat activity in the fallopian tube . CK was previously used in clinical practice to diagnose a myocardial infarction but it has also been shown that serum CK concentrations are significantly higher in women with ectopic pregnancy compared with women with missed miscarriage or viable intrauterine pregnancy . However, the results of subsequent studies have been conflicting and further research is necessary.…”