Study on the role of serum markers in the diagnosis of early ectopic pregnancy / 中国基层医药

ABSTRACT

Objective To evaluate the role of serum progesterone ( P) , β-subunit of human chrionic (β-HCG) and activin A( ACT A) in the diagnosis of ectopic pregnancy (EP). Methods The clinical data of 83 pregnant women were retrospectively reviewed. Serum P,β-HCG and ACT A were measured at visiting day(0 h) ,The values of β-HCG were measured again 48 h later. ROC curve was established and optimal operating point (OOP) of three indexes was ascertained,and the accuracy of each variable was evaluated. Results Serum P( 16.83 ± 15.71) nmol/L,48h/0h β-HCG (1.02 ±0.77) and ACT A(0. 26 ± 0.15)μg/L were significantly lower in ectopic pregnancy group compared with normal pregnancy group[(75. 74 ± 9. 76) nmol/L, (2. 53 ±0. 34) , (0. 49 ± 0. 43) μg/L] (P ＜ 0. 05). ROC curve showed that the highest accuracy rate in the diagnosis of EP was β-HCG 48h/0h( AUC =0.94), the second was progesterone( AUC =0.91) ,the lowest was ACTA( AUC =0.56). In addition,ROC curve showed all OOPs as followingserum P was 31.30nmol/L,48h/0h β-HCG was 1.25 ,ACTA was 0.43μg/L. When the three parameters were in the upper critical value,it had the higher accuracy rate in the diagnosis of EP. The combination of progesterone and β-HCG 48 h/0 h had higher sensitivity(98.4% ) and specificity(66.7% ) than the other two groups in the diagnosis of EP. Conclusion The combination of progesterone and p-HCG 48 h/0 h improved the accuracy rate in the diagnosis of EP, whereas estradiol had no diagnostic value in the diagnosis of EP.