Volume 10, Issue 4 (8-2012)                   IJRM 2012, 10(4): 303-306 | Back to browse issues page

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Asgharnia M, Faraji R, Mirblouk F, Atrkar Roshan Z, Parvizi A. Evaluation of serum creatine phosphokinase in diagnosis of tubal ectopic pregnancy compared with intrauterine pregnancy and threatened abortion. IJRM 2012; 10 (4) :303-306
URL: http://ijrm.ir/article-1-301-en.html
1- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Guilan, Iran
2- Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Guilan, Iran , royafaraji1371@yahoo.com
3- Department of Biostatistics, Guilan University of Medical Sciences, Guilan, Iran
Abstract:   (2881 Views)
Background: Vaginal sonograghy and serial -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.
Objective: assessment of CPK and its isoenzyme CPK-MB as a diagnostic marker for tubal pregnancy.
Materials and Methods: 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 βhCG 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. Results: 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.
Conclusion: It seems that determination of total CPK can enhance the diagnostic value of tubal pregnancy.
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Type of Study: Original Article |

References
1. Soundravally R, Soundara Raghavan S, Selvaraj N. Serum creatine kinase as a predictor of tubal ectopic pregnancy. Int J Gynaecol Obstet 2007; 98: 253-254. [DOI:10.1016/j.ijgo.2007.03.052]
2. Birkhahn RH, Gaeta TJ, Leo PJ, Bove JJ. The utility of maternal creatine kinase in the evaluation of ectopic pregnancy. Am J Emerg Med 2000; 18: 695-697. [DOI:10.1053/ajem.2000.7327]
3. Cabar FR, Fettback PB, Pereira PP, Zugaib M. Serum markers in the diagnosis of tubal pregnancy. Clinics (Sao Paulo) 2008; 63: 701-708. [DOI:10.1590/S1807-59322008000500021]
4. Segal S, Mercado R, Rivnay B. Ectopic pregnancy early diagnosis markers. Minerva Ginecol 2010; 62: 49-62.
5. Vitoratos N, Gregoriou O, Papadias C, Konidaris S, Kalogirou D, Kalampokis D, et al. Clinical value of creatinine kinase in the diagnosis of ectopic pregnancy. Gynecol Obstet Invest 1998; 46: 80-83. [DOI:10.1159/000010006]
6. Birkhahn RH, Gaeta TJ, Paraschiv D, Bove JJ, Suzuki T, Katoh H, et al. Serum levels of myoglobin, creatine phosphokinase, and smooth muscle heavy-chain myosin in patients with ectopic pregnancy. Ann Emerg Med 2001; 38: 628-632. [DOI:10.1067/mem.2001.119851]
7. Katsikis I, Rousso D, Farmakiotis D, Kourtis A, Diamanti-Kandarakis E, Zournatzi-Koiou V, et al. Creatine phosphokinase in ectopic pregnancy revisited: significant diagnostic value of its MB and MM isoenzyme fractions. Am J Obstet Gynecol 2006; 194: 86-91. [DOI:10.1016/j.ajog.2005.06.047]
8. Lavie O, Beller U, Neuman M, Ben-Chetrit A, Gottcshalk-Sabag S, Diamant YZ. Maternal serum creatine kinase: a possible predictor of tubal pregnancy. Am J Obstet Gynecol 1993; 169: 1149-1150. [DOI:10.1016/0002-9378(93)90272-K]
9. Develioglu OH, Askalli C, Uncu G, Samli B, Daragenli O. Evaluation of serum creatine kinase in ectopic pregnancy with reference to tubal status and histopathology. BJOG 2002; 109: 121-128. [DOI:10.1111/j.1471-0528.2002.00243.x]
10. Duncan WC, Sweeting VM, Cawood P, Illingworth PJ. Measurement of creatine kinase activity and diagnosis of ectopic pregnancy. Br J Obstet Gynaecol 1995; 102: 233-237. [DOI:10.1111/j.1471-0528.1995.tb09100.x]
11. Korhonen J, Alfthan H, Stenman UH, Ylöstalo P. Failure of creatine kinase to predict ectopic pregnancy. Fertil Steril 1996; 65: 922-924. [DOI:10.1016/S0015-0282(16)58261-2]
12. Vandermolen DT, Borzelleca JF. Serum creatine kinase does not predict ectopic pregnancy. Fertil Steril 1996; 65: 916-921. [DOI:10.1016/S0015-0282(16)58260-0]
13. Plewa MC, Ledrick D, Buderer NF, King RW. Serum creatine kinase is an unreliable predictor of ectopic pregnancy. Acad Emerg Med 1998; 5: 300-303. [DOI:10.1111/j.1553-2712.1998.tb02708.x]
14. Qasim SM, Trias A, Sachdev R, Kemmann E. Evaluation of serum creatine kinase levels in ectopic pregnancy. Fertil Steril 1996; 65: 443-445. [DOI:10.1016/S0015-0282(16)58114-X]
15. Gnisci A, Rua S, Courbiere B, Cravello L, Gamerre M, Agostini A. Plasma creatine phosphokinase level may predict successful treatment after a single injection of methotrexate for ectopic pregnancy. Fertil Steril 2011; 95: 2131-2133. [DOI:10.1016/j.fertnstert.2010.12.020]
16. Saha PK, Gupta I, Ganguly NK. Evaluation of serum creatine kinase as a diagnostic marker for tubal pregnancy. Aust N Z J Obstet Gynaecol 1999; 39: 366-367. [DOI:10.1111/j.1479-828X.1999.tb03418.x]
17. Kurzel RB, Mazdisnian F, Paige S, Liu P. Serum creatine kinase is not a reliable indicator of ectopic pregnancy. Int J Fertil Womens Med 2001; 46: 300-303.
18. Chandra L, Jain A. Maternal serum creatine kinase as a biochemical marker of tubal pregnancy. Int J Gynaecol Obstet 1995; 49: 21-23. [DOI:10.1016/0020-7292(95)02340-I]
19. Cartwright J, Duncan WC, Critchley HO, Horne AW. Serum biomarkers of tubal ectopic pregnancy: current candidates and future possibilities. Reproduction 2009; 138: 9-22. [DOI:10.1530/REP-09-0060]

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