Ectopic Pregnancy: Diagnosis and Management

Jennifer L Kulp; Kurt T Barnhart

Disclosures

Women's Health. 2008;4(1):79-87. 

In This Article

Future Perspective

Ideally, patients who are at risk for ectopic pregnancy could be screened for and treated earlier, therefore avoiding morbidity and mortality. A study looking at screening asymptomatic women using serum ß-hCG level, serum progesterone level and transvaginal ultrasound found a high false-positive rate.[43] Other investigators have looked for a serum-based marker that could be used to diagnose women with ectopic pregnancy. VEGF is elevated in ectopic pregnancies; however, it has low predictive values for these gestations.[44,45] A combination of three markers, VEGF, pregnancy-associated plasma protein-A and progesterone, has been shown to be 97.7% sensitive and 92.4% specific for ectopic pregnancy.[46] Other potential biochemical markers, including creatinine kinase, fetal fibronectin, serum leukemia inhibitory factor and smooth muscle heavy-chain myosin, have not been found to be useful in diagnosing ectopic pregnancies.[44,45,47,48,49,50,51,52] Gerton et al., who used a proteomic approach on serum from women with ectopic pregnancies with a goal of identifying serum markers, have found potential candidates that will need further characterization.[53]

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