title: Serum activin A levels are lower in tubal than intrauterine spontaneously conceived pregnancies.
abstract: OBJECTIVE
  To measure serum activin A levels together with progesterone and hCG, in women with overt clinical signs and symptoms of ectopic pregnancy (EP) and, in gestational age-matched intrauterine pregnancy (IUP).
  
  
  METHODS
  Retrospective case-control study.
  
  
  METHODS
  Department of Pediatrics, Obstetrics and Reproductive Medicine, Section of Obstetrics and Gynecology, University of Siena, Siena, Italy.
  
  
  METHODS
  The study group was composed by 30 women with an EP; the control group was composed by 30 women with a sonographic evidence of a single spontaneous IUP.
  
  
  METHODS
  Clinical examination; transvaginal ultrasound scan; hCG, progesterone and activin-A measurements; laparoscopy; uterine curettage; histological examination.
  
  
  METHODS
  Pregnancy outcome; sensitivity and specificity of hCG, progesterone, and activin A for EP.
  
  
  RESULTS
  Serum hCG levels did not differ significantly between tubal EP and IUP, while P concentrations were significantly (P < 0.001) lower in tubal EP than IUP. Serum levels of activin A were significantly (P < 0.0001) lower in tubal EP than in IUP and, at the cutoff 0.43 ng/mL achieved a sensitivity of 96.7% and a specificity of 100% for EP.
  
  
  CONCLUSIONS
  Activin A secretion in EP is reduced and measurement of its serum levels may have the potential clinical advantage to signal the presence of EP.
authors.affiliation: Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy. florio@unisi.it
authors.forename: Pasquale
authors.initials: P
authors.lastname: Florio
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Reis
authors.forename: Raffaele
authors.initials: R
authors.lastname: Battista
authors.forename: Stefano
authors.initials: S
authors.lastname: Luisi
authors.forename: Irene
authors.initials: I
authors.lastname: Moncini
authors.forename: Caterina
authors.initials: C
authors.lastname: Bocchi
authors.forename: Filiberto M
authors.initials: FM
authors.lastname: Severi
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D028341:Activins / Q000032:analysis / Q000097:blood*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D006063:Chorionic Gonadotropin / Q000097:blood; D015536:Down-Regulation; D005260:Female; D005306:Fertilization / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy / Q000097:blood*; D011271:Pregnancy, Ectopic / Q000097:blood*; D011274:Pregnancy, Tubal / Q000097:blood*; D011374:Progesterone / Q000097:blood; D012680:Sensitivity and Specificity; D014599:Uterus
chemical_list: D006063:Chorionic Gonadotropin; C422405:activin A; D028341:Activins; D011374:Progesterone