title: Clinical utility of serum reproductive hormones for the early diagnosis of ectopic pregnancy in the first trimester.
abstract: OBJECTIVE
  A tubal ectopic pregnancy (EP) in the first trimester remains a major life-threatening complication for the mother. We aim to determine whether serum reproductive hormones may be clinically useful in the early identification of a tubal EP.
  
  
  METHODS
  A total of 109 age-matched patients with a serum β-human chorionic gonadotropin (β-hCG) concentration <2000 IU/L were enrolled, including 68 patients with a tubal EP, 22 with a viable intrauterine pregnancy (vIUP) and 19 with a non-viable intrauterine pregnancy (nIUP). Serum was collected during the first trimester of pregnancy and assayed for β-hCG, follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (TE), progesterone (P), estradiol (E₂) and prolactin (PRL) by using automated electrochemiluminescence immunoassays.
  
  
  RESULTS
  Patients with an EP had significantly lower levels of daily β-hCG variation (Δβ-hCG/day), P and E₂, and significantly higher levels of LH and FSH than IUP patients (P<0.05). As an EP diagnostic marker, progesterone demonstrated a sensitivity of 100% at the cutoff of 86.01 nmol/L. The combination of E₂ with Δβ-hCG/day reached a specificity of 100% for EP evaluation. To identify non-viable pregnancies (including EPs and nIUPs), progesterone demonstrated a sensitivity of 95.40% and a specificity of 90.91% at the cutoff of 63.2 nmol/L; the diagnostic power of the receiver operating curve was 0.9702.
  
  
  CONCLUSIONS
  A combination of Δβ-hCG/day, P and E₂ may help distinguish EPs and nIUPs from vIUPs, facilitating earlier diagnosis and the timely implementation of medical treatment to prevent tubal rupture.
authors.affiliation: Department of Gynecology and Obstetrics, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Chun
authors.initials: C
authors.lastname: Feng
authors.forename: Zheng-Yun
authors.initials: ZY
authors.lastname: Chen
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.forename: Xin-Mei
authors.initials: XM
authors.lastname: Zhang
authors.forename: Xiu-Feng
authors.initials: XF
authors.lastname: Huang
mesh_terms: D015415:Biomarkers / Q000097:blood; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D042241:Early Diagnosis; D004958:Estradiol / Q000097:blood*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood*; D062145:Maternal Serum Screening Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011271:Pregnancy, Ectopic / Q000097:blood / Q000175:diagnosis*; D011274:Pregnancy, Tubal / Q000097:blood / Q000175:diagnosis; D011374:Progesterone / Q000097:blood*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D018997:Chorionic Gonadotropin, beta Subunit, Human; D011374:Progesterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone