ABSTRACT
We prospectively investigated the maternal serum level of beta- human chorionic gonadotropin [beta-hCG]progesterone [P], estradiol [E2], human placental lactogen [HPL], alfafetoprotein [AFP] and cancer antigen 125 [CA 125] during the first trimester of normal and abnormal pregnancies. Serum samples were obtained from 20 women with normal intra-uterine pregnancy [IUPs]. Fifteen whose pregnancies were complicated with spontaneous abortion and 31 with surgically and pathologically confirmed ectopic pregnancies [EPs]. The mean serum levels of beta-hCG, E2 and P in patients with EPs [9490.55 +/- 3071.2 mIU/ml, 100.1 +/- 22.09 pg/ml, 4.18 +/- 1.19 ng/ml, respectively] were significantly lower than those measured in normal IUPs [73796.8 +/- 15554.7 mIU/ml, 500.15 +/- 98.84 pg/ml, 19.2 +/- 2.8 ng/ml respectively [p<0.001] and significantly lower than in patients with spontaneous abortion [22524 +/- 6213 mIU/ml, p<0.05, 339.8 +/- 112.16 pg/ml, p<0.01, 10.59 +/- 3.03 ng/ml, p<0.05 respectively]. No significant difference was recorded with respect to serum levels of HPL, AFP and CA 125 among the groups. We also investigated the diagnostic value of simple E2 and P in patients with EPs. We could not identify a discriminatory cutoff value because there was a considerable overlap in serum P and E2 levels between the patients with IUPs and EPs. In conclusion, it is not possible to define a cutoff discriminatory value of P and E2 that completely separates ectopic from IUPs, but the addition of these assays to the workup of a patient with suspected EP may facilitate the earlier diagnosis of EP