OC090: The use of serial measurements of inhibin A and activin A to predict the outcome of pregnancies of unknown location

Abstract

Post-test odds (95% C.I.) Old protocol New protocol < 0.87 FAILING PUL 3.4 98% (96-99) Repeat serum hCG in 1 week If positive repeat weekly until negative Repeat serum hCG in 1 week

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

“…Early studies showed that the concentration of PAPPA was lower in patients with a tubal ectopic pregnancy when compared with normal intrauterine pregnancy (Bischof et al 1983, Sinosich et al 1985. Indeed, the serum concentration of PAPPA of ectopic pregnancy was sometimes within the Seppala & Purhonen (1987), Riss et al (1989), Garcia et al (1990), Guillaume et al (1990), Witt et al (1990), Mantzavinos et al (1991), Grosskinsky et al (1993), Kuscu et al (1993), Cacciatore et al (1994), Daily et al (1994), Korhonen et al (1996), O'Leary et al (1996), Mol et al (1997), Marill et al (1999) Kirk et al (2008) Serum biomarkers of tubal ectopic pregnancy non-pregnant range (Bischof et al 1983). 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).…”

“…When using activin A as a single marker, the authors calculated that for their study population (tubal ectopic pregnancy prevalence 14.18%), a tubal ectopic pregnancy could be identified with a sensitivity of 100% and specificity of 99.6% if the cut-off was !0.37 ng/ml. Disappointingly, a preliminary report of the use of activin A as a single biomarker for the diagnosis of tubal ectopic pregnancy in a different population of women has been less encouraging, with a much lower specificity and sensitivity (Kirk et al 2008). Although it is not being used in clinical practice, activin A remains a potentially important biomarker that is worthy of further study.…”