The value of vascular endothelial growth factor, pregnancy-associated plasma protein-A, and progesterone for early differentiation of ectopic pregnancies, normal intrauterine pregnancies, and spontaneous miscarriages

Objective To evaluate the capacity of vascular endothelial growth factor (VEGF), pregnancy-associated plasma protein-A (PAPP-A), and progesterone (P) to discriminate ectopic pregnancies (EP) from nonectopic ones. Design Prospective, case-controlled study. Setting Tertiary care center. Patient(s) Twe...

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Bibliographic Details
Published in:Fertility and sterility 2009-05, Vol.91 (5), p.1657-1661
Main Authors: Ugurlu, Evin Nil, M.D, Ozaksit, Gulnur, M.D, Karaer, Abdullah, M.D, Zulfikaroglu, Ebru, M.D, Atalay, Aral, M.D, Ugur, Mustafa, M.D
Format: Article
Language:English
Subjects:
Abortion, Spontaneous - diagnosis
Adult
Biological and medical sciences
Case-Control Studies
Diagnosis, Differential
Diseases of mother, fetus and pregnancy
Ectopic pregnancy
Female
Gynecology. Andrology. Obstetrics
Humans
Internal Medicine
Medical sciences
Obstetrics and Gynecology
PAPP-A
Pregnancy
Pregnancy, Ectopic - diagnosis
Pregnancy-Associated Plasma Protein-A - analysis
Pregnancy. Fetus. Placenta
Progesterone - blood
Prospective Studies
sensitivity
specifity
Vascular Endothelial Growth Factor A - blood
VEGF
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Summary:Objective To evaluate the capacity of vascular endothelial growth factor (VEGF), pregnancy-associated plasma protein-A (PAPP-A), and progesterone (P) to discriminate ectopic pregnancies (EP) from nonectopic ones. Design Prospective, case-controlled study. Setting Tertiary care center. Patient(s) Twenty-nine women with EP, 29 women with normal intrauterine pregnancy (nIUP), and 28 women with spontaneous miscarriage, all matched for gestational age. Intervention(s) Serum samples were obtained. Main Outcome Measure(s) Serum concentrations of VEGF, PAPP-A, and P were measured. Result(s) Serum VEGF concentrations did not show statistically significant differences among women with EP (median, 55.24 pg/mL; range, 0.20–179.24), spontaneous miscarriages (median, 26.24 pg/mL; range, 0.22–365.24), and nIUP (median, 43.24 pg/mL; range, 0.86–101.24). The median level of P was significantly increased in the nIUP group (20.58 ng/mL; range, 13.9–37.04) compared with the other two groups, but there was no statistically significant difference between the spontaneous miscarriage and EP groups. Like P, PAPP-A values were also significantly higher in the nIUP group than in the other two groups, but the difference between PAPP-A values in the EP and spontaneous abortion groups was statistically insignificant. Conclusion(s) VEGF, PAPP-A, and P cannot be used to diagnose EPs, but PAPP-A and P can at least be used to differentiate abnormal pregnancies.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2008.02.002