CONTEXT: The diagnosis of an ectopic pregnancy (EP) requires the usage of serial beta-human chorionic gonadotropin (hCG) measurements and ultrasonography to locate the gestational sac. With the rising trends in its incidence, a rapid, noninvasive biomarker to detect this condition at the earliest can aid in decreasing the morbidity and mortality linked with EP. AIMS: This study was performed to determine the serum level of soluble FMS-like tyrosine kinase-1 (sFLT-1) at 4–10-week gestation in EP and normal pregnancy and to identify whether it can be used as a biomarker to distinguish an EP from a normal intrauterine pregnancy. SETTINGS AND DESIGN: This was a prospective case–control study conducted over 2 years from 2015 to 2017 in 280 women between the age groups of 19 and 38 years at a tertiary level hospital. SUBJECTS AND METHODS: Levels of sFLT-1 in sera of 140 women with EP and 140 women with normal pregnancy were assayed by a sandwich enzyme-linked immunosorbent assay at Sri Ramachandra Medical College and Research Institute, Chennai, Tamil Nadu, India. STATISTICAL ANALYSIS USED: Statistical analyses were performed with SPSS software version 16.0, and P ≤ 0.05 was considered statistically significant. RESULTS: The median sFLT-1 level in EP was 419 pg/ml. This was significantly lower than the value of 898 pg/ml in normal pregnancy. Receiver operating characteristic curve analysis showed that at a cutoff of 623 pg/ml, sFLT-1 was able to distinguish an EP from a normal intrauterine pregnancy with a sensitivity of 98.6% and a specificity of 90.7%. CONCLUSIONS: The present study showed the significant early lowering of sFLT-1 in EP and may be considered as an effective biomarker compared to beta-hCG.

BACKGROUND MicroRNAs (miRs) belong to a category of small non-coding RNAs that perform important functions as gene regulators. These miniscule, roughly ~20 nucleotide RNAs have been phylogenetically well preserved and have widespread roles in transcription and translation. Since discovery in 1993, numerous miRs in various species have been documented and a common nomenclature has been adopted. Biogenetic pathways of these unique small RNAs are divided into canonical and noncanonical pathways, based on their dependence or independence on Drosha/DGCR8 and Dicer for processing. The common method of gene silencing is via mRNA cleavage or translational repression. In certain scenarios, they have also been found to activate protein synthesis. The dynamic interactions of miRs with their target DNA depends on numerous factors like their affinity, location and abundance. The turnovers of miRs are dictated by numerous modifications like uridylation and adenylation. Whenever new miRs are detected, their expression, conservation and experimental quantification are used to find novel gene pathways and their target mRNA. MiRs have been released into circulation, either in vesicles or bound to proteins. Extracellular presence of miRs may be a consequence of cell death or injury; but more regulated processes like endocytosis and pinocytosis also seem to have some role. The variation in expression and type of circulating miRs has been studied as markers of disease manifestations.

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