Evaluation of serum creatine phosphokinase in diagnosis of tubal ectopic pregnancy compared with intrauterine pregnancy and threatened abortion

ABSTRACT

Vaginal sonograghy and serial beta-hCG are the most common diagnostic methods for ectopic pregnancy but about 50% of cases are initially misdiagnosed. In tubal pregnancy the zygote lies next to the muscular layer, and this invasion causes an increase in creatine phosphokinase [CPK] in blood. assessment of CPK and its isoenzyme CPK-MB as a diagnostic marker for tubal pregnancy. In this case-control study, 111 women between 16-40 years in first-trimester pregnancy admitted to emergency ward of Rasht Alzahra hospital with abdominal pain or vaginal bleeding were included and according to sonography and beta-hCG divided into 3 groups [N=37] tubal pregnancy [1], threatened abortion [2] and normal pregnancy [3]. Blood samples were taken for totalCPK and CPK-MB before any invasive procedure. Mean total CPK level were 96.27 +/- 63.9 u/lit [group 1], 55.37 +/- 14.1 u/lit [group 2] and 48.94 +/- 19.2 u/lit [group 3] and was significantly higher in tubal pregnancy compared to other groups. Mean CPK-MB levels in 3 groups were 15.62 +/- 5.2 u/lit, 17.32 +/- 6.9 u/lit, and 15.1 +/- 4.7 u/lit, respectively which was not significant. It seems that determination of total CPK can enhance the diagnostic value of tubal pregnancy