The value of vascular endothelial growth factor, pregnancy-associated plasma protein-A, and progesterone for early differentiation of ectopic pregnancies, normal intrauterine pregnancies, and spontaneous miscarriages

Ugurlu, Evin Nil; Özakşit, Gülnur; Karaer, Abdullah; Zülfikaroğlu, Ebru; Atalay, Aral; Uğur, Mustafa

doi:10.1016/j.fertnstert.2008.02.002

Cited by 28 publications

(19 citation statements)

References 27 publications

(25 reference statements)

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“…These associated symptoms are also not consistent with stage of the disease progression at time of presentation for evaluation. Patients may present in the early phase of ectopic pregnancy with minimal symptoms due to levels of progesterone, estradiol, and beta-HCG being lower than in normal pregnancy [8][9][10]. Such cases may be treated with either observation or methotrexate administration without invasive procedures.…”

Section: Discussionmentioning

confidence: 99%

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2016

OGIJ

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Background: During the first trimester of pregnancy, ectopic pregnancy is the leading cause of maternal mortality. Diagnosis and management of ectopic pregnancies require that health care providers maintain vigilance. Providing a variety of surgical and medical treatments at night can be challenging to the on call team in a teaching hospital. We present four cases of ectopic pregnancies managed over a 15 hour period by the night on call gynecology team.Cases: Case 1, 26-year-old women diagnosed with a ruptured ectopic pregnancy that required emergent laparotomy and blood transfusion. In Case 2, 27-year-old women underwent dilation, curettage and minimal invasive surgery of operative laparoscopy for ruptured ectopic pregnancy. In Case 3, a 24-year-old woman with unruptured ectopic pregnancy was treated with methotrexate. In Case 4, 35 yearold women underwent minimal invasive operative laparoscopy for unruptured ectopic pregnancy. Conclusion:Despite technological advances in early diagnosis of ectopic pregnancy with the use of transvaginal sonogram and serial β-HCG titers, patients still present to the emergency department with ruptured ectopic pregnancy necessitating acute surgical interventions. This is especially prevalent in inner city hospital catchment area where patients often wait until development of severe symptoms before presenting for medical care. Therefore, diagnosis of ectopic pregnancies warrens a high index of suspicion and treatment plans that are individualized, particularly to area of services with attention to patient compliance.

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Section: Discussionmentioning

confidence: 99%

Untitled

2016

OGIJ

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“…Rapidement, après l'implantation, l'hCG est présent dans le sang maternel au même titre que d'autres protéines produites par le tissu trophoblastique (pregnancy-associated plasma protein A [PAPP-A], pregnancy-specific beta 1 glycoprotein [SP1], human placental lactogen [HPL], leukemia inhibitory factor [LIF], activine A et inhibine A). Ces protéines sont également produites lors d'une grossesse ectopique mais à des concentrations plus faibles comme c'est le cas pour l'hCG [17][18][19]. La plus faible production de protéines placentaires par le trophoblaste est certainement en rapport avec un volume placentaire plus faible pour le même âge gestationnel lors d'une grossesse ectopique que lors d'une grossesse normale [18].…”

Section: Autres Marqueurs Placentairesunclassified

“…La plus faible production de protéines placentaires par le trophoblaste est certainement en rapport avec un volume placentaire plus faible pour le même âge gestationnel lors d'une grossesse ectopique que lors d'une grossesse normale [18]. Cependant, la différence de concentration entre les GEU et les fausses couches spontanées est insignifiantes pour les principaux marqueurs (PAPP-A, LIF, HPL) [17,20]. Aussi, les marqueurs placentaires pris isolément ne peuvent être utilisés comme marqueur du diagnostic de GEU [17,19,20] …”

Section: Autres Marqueurs Placentairesunclassified

“…Cependant, la différence de concentration entre les GEU et les fausses couches spontanées est insignifiantes pour les principaux marqueurs (PAPP-A, LIF, HPL) [17,20]. Aussi, les marqueurs placentaires pris isolément ne peuvent être utilisés comme marqueur du diagnostic de GEU [17,19,20] …”

Section: Autres Marqueurs Placentairesunclassified

“…Par exemple, Daponte et al, sur une population comportant 48 patientes (27 GEU, 21 GIU) un taux de VEGF supérieur à 174,5 pg/mL permet le diagnostic de GEU avec une sensibilité de 78 % et une spécificité de 100 %. Cependant, d'autres auteurs, sur des effectifs plus élevés, n'ont pas confirmé la corrélation entre le taux de VEGF et le diagnostic de GEU [17,25].…”

Section: Vascular Endothelial Growth Factorunclassified

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Place de la biologie parmi les stratégies diagnostiques de la grossesse extra-utérine

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Nanomedicines for Improved Management of Ectopic Pregnancy: A Narrative Review

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Ectopic pregnancy (EP) – the implantation of an embryo outside of the endometrial cavity, often in the fallopian tube – is a significant contributor to maternal morbidity and leading cause of maternal death due to hemorrhage in first trimester. Current diagnostic modalities including human chorionic gonadotropin (hCG) quantification and ultrasonography are effective, but may still misdiagnose EP at initial examination in many cases. Depending on the patient's hemodynamic stability and gestational duration of the pregnancy, as assessed by history, hCG measurement and ultrasonography, management strategies may include expectant management, chemotherapeutic treatment using methotrexate (MTX), or surgical intervention. While these strategies are largely successful, expectant management may result in tubal rupture if the pregnancy does not resolve spontaneously; MTX administration is not always successful and may induce significant side effects; and surgical intervention may result in loss of the already‐damaged fallopian tube, further hampering the patient's subsequent attempts to conceive. Nanomaterial‐based technologies offer the potential to enhance delivery of diagnostic imaging contrast and therapeutic agents to more effectively and safely manage EP. The purpose of this narrative review is to summarize the current state of nanomedicine technology dedicated to its potential to improve both the diagnosis and treatment of EP.

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The value of vascular endothelial growth factor, pregnancy-associated plasma protein-A, and progesterone for early differentiation of ectopic pregnancies, normal intrauterine pregnancies, and spontaneous miscarriages

Cited by 28 publications

References 27 publications

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Place de la biologie parmi les stratégies diagnostiques de la grossesse extra-utérine

Nanomedicines for Improved Management of Ectopic Pregnancy: A Narrative Review

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