Using dynein heavy chain 5 and creatine kinase levels in cervical fluid and blood for early diagnosing of ectopic pregnancy

Abstract

Aim Ectopic pregnancy is a life‐threatening problem in reproductive ages. Diagnosing ectopic pregnancy in the early period provides to reducing mortality and morbidity and gives an opportunity for medical treatment to preserve fallopian tubes. Evaluation of cervical fluid for determining ectopic pregnancy with new promising markers provided different aspects for diagnosing ectopic pregnancy in the present study. Methods In this prospective clinical study, ectopic pregnant patients as ectopic pregnancy group (n = 46), intrauterine pregnant patients as intrauterine pregnancy group (n = 29) and not‐pregnant patients as nonpregnancy group (n = 10) participated to study. Cervical fluid samples were collected with using merocel sponge. In addition, serum samples were obtained from patients. Dynein heavy chain 5 (DNAH5) and creatine kinase (CK) levels were determined by enzyme‐linked immunosorbent assay kits in samples. Results Reduced cervical fluid DNAH5 levels was diagnosed in ectopic pregnancy group compared to intrauterine pregnancy group (median 3.42 ng/mL; 25–75% percentile 0–9.56 ng/mL vs median 6.14 ng/mL; 1.40–8.31 ng/mL; P < 0.001). On the other hand, DNAH5 protein was not detected in nonpregnant patients' samples. In addition, statistical significant increased cervical fluid CK levels were diagnosed in ectopic pregnancy group compared to intrauterine pregnancy group (median 4477.61 IU/L; 0–64 925.37 IU/L vs 0 IU/L; 0–6832.30 IU/L; P = 0.006). Conclusion Measuring of CK and DNAH5 in cervical fluid could be promising markers for early diagnosing of ectopic pregnancy. Decreased DNAH5 levels in cervical fluid might be result from abnormal cilia function in ectopic pregnant patients. ClinicalTrials.gov ID. NCT02995356.

Association Between Vaginal Gardnerella and Tubal Pregnancy in Women With Symptomatic Early Pregnancies in China: A Nested Case-Control Study

“…Therefore, early diagnosis and intervention are essential for safeguarding pregnant women against these complications. Although some progress has been made, there are currently no standard measures in place for the early diagnosis of tubal implantation ( Carusi, 2019 ; Chen et al., 2020 ; Sahin et al., 2021 ). Although the mechanism of TP is complex, the majority of relevant studies indicate that inflammation of the fallopian tube or the surrounding pelvic tissues, due to factors such as the presence of pelvic inflammatory disease (PID) or Chlamydia trachomatis (CT) infection ( Xia et al., 2020 ), is central to TP development ( Shao et al., 2009 ; Al-Azemi et al., 2010 ; Li et al., 2013 ).…”

Comparisons of Fertility Outcomes Following a Salpingectomy and a Salpingotomy with or Without Suturing for a Tubal Ectopic Pregnancy

“…An ectopic pregnancy (EP) is defined as any pregnancy that does not implant into the uterine cavity; its rate of occurrence comprises 1%–2% of all pregnancies. 1 , 2 The most common site for an EP is the fallopian tube (tubal EP). 3 , 4 Reports indicate that more than 95% of EPs are detected in the ampulla, fimbrial and isthmic portions of the fallopian tube.…”

“…It can acutely rupture and remains the primary cause of mortality in the first trimester of pregnancy. 1 , 6 …”

“…It can acutely rupture and remains the primary cause of mortality in the first trimester of pregnancy. 1,6 The treatments for tubal EP include medical (methotrexate, [MTX]) and surgical procedures. Surgical treatment is preferred for patients receiving ruptured tubal EP management or patients with a stable EP when medical therapy has failed.…”

Embarazo ectópico cervical. Presentación de caso clínico

“…Clínicamente se destaca como signo principal el sangrado transvaginal, un pequeño porcentaje de pacientes son asintomáticas, y solo un tercio de las pacientes presentan dolor y calambres abdominales inferiores (5) Serológicamente se realiza medición de los niveles plasmáticos de gonadotropina coriónica humana (β-HCG), medidos durante un período de 2 días, Un aumento de estos niveles, indica la presencia de embarazo ectópico, con una sensibilidad del 83,2% y una especificidad del 70,8%. La sensibilidad y la especificidad podrían aumentar si además se miden niveles de progesterona, Sin embargo, el uso de este método para diagnosticar un embarazo ectópico puede resultar en retrasos en el tratamiento (6).…”