Evaluation of serum creatine kinase in ectopic pregnancy with reference to tubal status and histopathology

Authors: Develioglu, Osman H.¹; Askalli, Cenk¹; Uncu, Gurkan¹; Samli, Billur²; Daragenli, Omer¹

Source: BJOG: An International Journal of Obstetrics & Gynaecology, Volume 109, Number 2, February 2002 , pp. 121-128(8)

Publisher: Wiley-Blackwell

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Abstract:

Objective

To study the value of creatine kinase in ectopic pregnancy with reference to tubal histopathology. Design

Prospective controlled study. Setting

Academic tertiary-care institution. Population

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

Creatine kinase and β-hCG levels were measured on admission. Ectopic pregnancies were removed at surgery and examined histologically. Main outcome measures

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.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2002.00243.x

Affiliations: 1: Department of Obstetrics and Gynaecology, School of Medicine, Uludag University, Bursa, Turkey 2: Department of Pathology, School of Medicine, Uludag University, Bursa, Turkey

Publication date: 2002-02-01

Evaluation of serum creatine kinase in ectopic pregnancy with reference to tubal status and histopathology

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