Novel placental and nonplacental serum markers in ectopic versus normal intrauterine pregnancy

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

“…A subsequent larger study found that PAPPA was undetectable in 84.8% of samples from women (nZ102) with tubal ectopic pregnancy, but it was also undetectable in 55% of intrauterine spontaneous abortions (Sjoberg 1987). It seems that serum PAPPA concentrations are very low before 7 weeks of gestation and in isolation are poorly discriminative between spontaneous abortion and tubal ectopic pregnancy (Mueller et al 2004, Daponte et al 2005.…”

“…An initial study found that there were no differences in serum concentrations between ectopic and intrauterine pregnancies (Kuscu et al 1993). However, a subsequent study involving a number of placental proteins showed that HPL levels were lower in those with tubal ectopic pregnancy compared with normal intrauterine pregnancy, particularly after 7 weeks of gestation (Mueller et al 2004). Although this finding has been confirmed in a different set of patients (Daponte et al 2005), the marked overlap in values between groups limits its utility as a clinically useful biomarker.…”

“…Serum SP-1 concentrations do tend to be lower in tubal ectopic pregnancy (Tornehave et al 1987), but again larger studies have confirmed that there is poor discrimination between tubal ectopic pregnancy (nZ32) and spontaneous abortion (nZ42; Witt et al 1990). In tubal ectopic pregnancy, serial SP-1 measurements reached a plateau, while in ongoing pregnancy they continue to increase (Mantzavinos et al 1991, Mueller et al 2004) and the differences were most marked after 7 weeks of gestation.…”

Molecular diagnosis of ectopic pregnancy

“…Others have evaluated alternative marker combinations, including: inflammatory cytokines IL-6, IL-8 and TNF-a [17]; PAPP-A, inhibin A and activin A [18]; and cancer antigen-125 and CK [19] to identify women with EP, with varied success. Progesterone, inhibin and human chorionic gonadotrophin have also been combined to distinguish viable from nonviable IUP [20].…”

Clinical Application of One-Step Diagnosis for Ectopic Pregnancy by HCG Ratio: Hemoperitoneum Versus Venous Serum

“…Certain serum biomarkers have been shown initially to be of discriminatory value but then subsequent studies have found them to be of limited use (such as placental protein 14) (Daponte, et al, 2008;Mantzavinos, et al, 1991.). A number of biomarkers (such as estradiol, pregnancy associated plasma protein A, cancer antigen 125) can distinguish a tubal ectopic from a viable intrauterine pregnancy but are unable to distinguish the former from a nonviable intrauterine pregnancy (miscarriage) (Mueller, et al, 2004;Katsikis, et al, 2006). Note: IUP: intrauterine pregnancy; PUL: pregnancies of unknown location; SEP: suspected ectopic pregnancy; GS: gestational sac; FH: fetal heart; Rp/v-hCG: hCG ration of peritoneum versus venous serum.…”