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Hum. Reprod. Advance Access published online on July 29, 2005
Human Reproduction, doi:10.1093/humrep/dei218
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.
Received April 8, 2005
Revised June 13, 2005
Accepted July 1, 2005

Article

The value of a single combined measurement of VEGF, glycodelin, progesterone, PAPP-A, HPL and LIF for differentiating between ectopic and abnormal intrauterine pregnancy

A. Daponte 1, S. Pournaras 2, E. Zintzaras 3, A. Kallitsaris 1, G. Lialios 1, A.N. Maniatis 2, and I.E. Messinis 1*

1 Department of Obstetrics and Gynaecology, University of Thessalia, 22 Papakiriazi Street, 41222 Larissa, Greece
2 Department of Microbiology, University of Thessalia, 22 Papakiriazi Street, 41222 Larissa, Greece
3 Department of Biostatistics, University of Thessalia, 22 Papakiriazi Street, 41222 Larissa, Greece

* To whom correspondence should be addressed.
I.E. Messinis, E-mail: messinis{at}med.uth.gr


  Abstract

BACKGROUND: To evaluate whether serum concentrations of the non-placental markers vascular endothelial growth factor (VEGF), glycodelin (GLY) and progesterone (P) and the novel placental markers pregnancy-associated plasmaprotein A (PAPP-A), human placental lactogen (HPL) and leukaemia inhibiting factor (LIF) differ in ectopic pregnancy (EP) when compared with abnormal intrauterine pregnancy (aIUP). METHODS: A prospective clinical study was conducted at the University Hospital of Larissa, Greece. The study included 50 patients admitted with failed pregnancy and suspected ectopic pregnancy that were treated with curettage or laparoscopy and classified as histologically confirmed EPs (n = 27) or histologically confirmed aIUPs (n = 21) (mean gestational age of 7.15 and 7.3 weeks, respectively). Two suspected EPs proved to be normal IUPs and were excluded. VEGF, GLY, P,{beta}-HCG, PAPP-A, HPL and LIF were measured by enxyme-linked immunosorbent assay (ELISA) methods in a single pre-operative blood sample. RESULTS: The median VEGF concentration was 227.2 pg/ml in the EP group versus 107.2 pg/ml in the aIUP group (P < 0.001), with a suggested threshold value of 174 pg/ml for their differential diagnosis. LIF, P, PAPP-A, HPL and GLY serum measurements did not differ significantly between EP and aIUP. CONCLUSION: VEGF serum levels might be a useful marker in differentiating between EPs and aIUPs.

Keywords: ectopic pregnancy/incomplete abortion/non-placental markers/placental markers.
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