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
Received 9 June 2007; received in revised form 4 February 2008; accepted 4 February 2008. published online 09 April 2008.
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.
Dr. Zekai Tahir Burak Woman Health Education and Research Hospital, Department of Obstetrics and Gynecology, Ankara, Turkey
Reprint requests: Evin Nil Ugurlu, M.D., Talatpaşa Bulvarı, Hamamönü, Cebeci, Ankara, Turkey (FAX: +903123124931).
E.N.U. has nothing to disclose. G.O. has nothing to disclose. A.K. has nothing to disclose. E.Z. has nothing to disclose. A.A. has nothing to disclose. M.U. has nothing to disclose.
ABSTRACT