Hematological and Biochemical Changes Associated with Ectopic Pregnancy in Jazan Area Saudi Arabia

Abstract

Objective: Ectopic pregnancy (EP) is an implantation of fertilized ovum outside the intrauterine cavity. Many cases of EP are not associated with a clinical signs at early stages that makes its diagnosis is difficult. The confirmation of EP needs several investigations as ultrasonography and repeated measurements of serum β-hCG levels every 48 hours that make it very expensive and take a long time so, rupture may be occurred that leads to increased maternal morbidity and mortality rates. Thus, the aim of this study was to investigate the alterations of some hematological and biochemical parameters associated with normal and ectopic pregnancy in addition to evaluate their efficacy in early diagnosis of tubal ectopic pregnancy (TEP) among women living in Jazan area, Kingdom of Saudi Arabia. Subjects and methods: this retrospective study was carried out on 200 women with their ages ranged from 25-37 years old at the Obstetric and Gynecology Department of King Fahd Central Hospital and Sabiya General Hospital during the period between March 2010 and March 2014. The subjects were divided into three groups. Group (1) consists of 69 cases ruptured EP; Group (2) consists of 61 cases non-ruptured by visual examination during surgery and subsequently histopathological examination, where as group (3) consists of 70 women representing the control group having a normal intrauterine pregnancy. Hematological and biochemical measurements were done on all groups. Results: the hematological findings revealed a significant increase in mean platelet volume (MPV), total leukocytic count (WBC) and erythrocyte sedimentation rate (ESR) among TEP patients especially in ruptured cases in comparison with those of normal pregnancy control. A significant decrease in hemoglobin (Hb) and packed cell volume (PCV) in TEP cases either ruptured or nonruptured and a non-significant changes in total erythrocytic count (RBC). The biochemical findings revealed a significant increase in serum creatine kinase (CK) but a significant decrease in serum β-hCG in both ruptured and non-ruptured TEP. Conclusion: it could be concluded that theWBCs,MPV count and ESR were significantly increased in TEP especially in ruptured cases. The MPV can differentiate between TEP and normal pregnancy but has less clinical significance to differentiate between ruptured and non-ruptured cases. On the other hand, the level of β-hCG is an important indicator of TEP. Moreover, serum CK cannot be used as a tool for diagnosis of TEP but may differentiate between ruptured and non-ruptured cases.