title: Evaluation of serum creatine phosphokinase in diagnosis of tubal ectopic pregnancy compared with intrauterine pregnancy and threatened abortion.
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  It seems that determination of total CPK can enhance the diagnostic value of tubal pregnancy.
authors.affiliation: Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Guilan, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Asgharnia
authors.affiliation: Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Guilan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Faraji
authors.affiliation: Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Guilan, Iran.
authors.forename: Fariba
authors.initials: F
authors.lastname: Mirblouk
authors.affiliation: Department of Biostatistics, Guilan University of Medical Sciences, Guilan, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Atrkar Roshan
authors.affiliation: Reproductive Health Research Center, Department of Obstetrics and Gynecology, Guilan University of Medical Sciences, Guilan, Iran.
authors.forename: Ayda
authors.initials: A
authors.lastname: Parvizi
keywords: Creatine phosphokinase; Intrautine pregnancy; Threatened abortion; Tubal ectopic pregnancy