Evaluation of serum creatine kinase in ectopic pregnancy with reference to tubal status and histopathology.
OBJECTIVE
To study the value of creatine kinase in ectopic pregnancy with reference to tubal histopathology.


METHODS
Prospective controlled study.


METHODS
Academic tertiary-care institution.


METHODS
Thirty-two women with ectopic pregnancy and 20 controls with intrauterine pregnancies.


METHODS
Creatine kinase and beta-hCG levels were measured on admission. Ectopic pregnancies were removed at surgery and examined histologically.


METHODS
Tubal localisation and integrity of ectopic pregnancies as judged at surgery and later histologically, and placental growth patterns in unruptured ectopic pregnancies classified as intraluminal, extraluminal or mixed as determined histologically.


RESULTS
Creatine kinase levels were higher in isthmic than ampullary ectopic pregnancies (P = 0.011), and higher in ruptured than in unruptured cases (P = 0.003) and normal pregnancies (P < 0.0001). A creatine kinase value >120iu/L was 65% sensitive and 87% specific in discriminating ruptured from unruptured ectopic pregnancies. Creatine kinase levels were above this cutoff in two of five unruptured ampullary ectopic pregnancies with invasive trophoblastic growth, yet in none of nine cases with intraluminally confined placentation (P = 0.04). Creatine kinase was positively correlated with gestational age in ruptured (P = 0.007), but not in unruptured ectopic pregnancies or normal pregnancies.


CONCLUSIONS
Serum creatine kinase may help in discriminating ruptured from unruptured ectopic pregnancies, while it is not useful for the primary diagnosis of ectopic pregnancy. An increase in creatine kinase levels accompanying muscular damage in ectopic pregnancy probably antedates tubal rupture, and may be related to trophoblastic growth patterns.
Develioglu
Osman H
OH
Department of Obstetrics and Gynaecology, School of Medicine, Uludag University, Gorukle, Bursa, Turkey.
Askalli
Cenk
C
Uncu
Gurkan
G
Samli
Billur
B
Daragenli
Omer
O
D000328:Adult; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D003402:Creatine Kinase / Q000097:blood*; D005187:Fallopian Tubes / Q000473:pathology*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood* / Q000473:pathology; D011446:Prospective Studies; D012422:Rupture, Spontaneous; D014327:Trophoblasts / Q000502:physiology
D018997:Chorionic Gonadotropin, beta Subunit, Human; D003402:Creatine Kinase