Maternal serum creatine Kinase and single serum progesterone measurement as predictors of ectopic pregnancy

ABSTRACT

To evaluate the role of maternal serum creatine kinase and single serum progesterone measurements in the prediction of ectopic pregnancy. The study was conducted at A-Khadhimya Teaching Hospital, department of obstetrics and gynecology during the period from March 2001 through April 2002. The study included 60 women divided into 3 groups Group A Twenty patients with ectopic pregnancy confirmed by surgery and histopathology. Group B Twenty patients with non continuing pregnancy [missed abortion or spontaneous abortion] of comparable gestational age. Group C Twenty women with normal intrauterine pregnancy of comparable gestational age. The following laboratory measurements for the studied groups were done serum age. The following laboratory measurements for the studied groups were done serum creatine kinase, serum progesterone levels and histopathological study to determine the depth of invasion of the trophoblast to the muscular layer of the fallopian tube for group A. The mean serum creatine kinase was significantly higher in group A than in groups B and C [P<0.0001] and the mean serum progesterone level was significantly lower in groups A and B than in group C [P<0.0001]. The mean serum creatine kinase level was significantly higher in ruptured ectopic pregnancy than in the unruptured [P<0.0003], and in isthmic than in ampullary ectopic pregnancy [P<0.007]. In addition, the mean serum progesterone level was significantly higher in ruptured than in the unruptured ectopic pregnancy [P<0.01]. There was a significant positive correlation between serum creatine kinase and progesterone level in group A. There was an increase in the serum creatine kinase levels accompanying muscular damage in ectopic pregnancy probably antedates tubal rupture and could help in discriminating ruptured from unruptured ectopic pregnancy. The combined use of both serum creatine kinase and serum progesterone in patients with suspected ectopic pregnancy has a higher differential accuracy than either analysis alone