Vascular endothelial growth factor (VEGF) and discrimination between abnormal intrauterine and ectopic pregnancy

Kucera-Sliutz, Elisabeth; Schiebel, Ingrid; König, Franz; Leodolter, Sepp; Sliutz, Gerhard; Koelbl, Heinz

doi:10.1093/humrep/17.12.3231

Cited by 19 publications

(13 citation statements)

References 25 publications

(47 reference statements)

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“…These investigators have concluded that serum levels of VEGF are significantly higher in women with EPs than in those with intrauterine pregnancies (9,13,14). Another study concluded that the VEGF level could not discriminate EP from abnormal intrauterine pregnancy (15). In our study, although we found higher serum VEGF values in the EP group than in the spontaneous miscarriage and nIUP groups, this difference was not statistically significant.…”

Section: Discussioncontrasting

confidence: 89%

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

Özakşit

Karaer

et al. 2009

Fertility and Sterility

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Section: Discussioncontrasting

confidence: 89%

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

Özakşit

Karaer

et al. 2009

Fertility and Sterility

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“…Using the same cut-off, Felemban et al (2002) reported that all 15 women they tested with an intrauterine pregnancy had a serum VEGF of !200 pg/ml and they were able to distinguish a tubal ectopic pregnancy with a sensitivity of 88%, specificity of 100% and PPV of 100%. Another study at the same time (nZ84), however, failed to find statistical differences between serum VEGF concentrations between women with a tubal ectopic pregnancy and those with a failing intrauterine pregnancy (Kucera-Sliutz et al 2002) and the discrimination was poor with a sensitivity of 56%, specificity of 51% and PPV of 53%. However, when normal intrauterine pregnancy is compared with tubal ectopic pregnancy, serum VEGF correlations do appear to be consistently elevated (Mueller et al 2004).…”

Section: Vascular Endothelial Growth Factormentioning

confidence: 94%

Serum biomarkers of tubal ectopic pregnancy: current candidates and future possibilities

Cartwright¹,

Duncan²,

Critchley³

et al. 2009

Reproduction

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Ectopic pregnancy remains a considerable cause of maternal morbidity and mortality worldwide. Currently, it is diagnosed using a combination of transvaginal ultrasound and serial serum b-human chorionic gonadotrophin levels. Diagnosis is often delayed and these tests are time-consuming and costly, both psychologically to the patient and financially to health services. The development of a biomarker that can differentiate a tubal ectopic from an intrauterine implantation is therefore important. In the pre-genomic era, a one-by-one scientific approach has revealed over 20 candidate biomarkers that could be used as a test to diagnose ectopic pregnancy although at present their clinical utility is very limited. These biomarkers cluster into themes: markers of abnormal embryo/trophoblast growth, markers of abnormal corpus luteum function, markers of a growing pregnancy in the Fallopian tube, markers of inflammation and peritoneal irritation, and uterine markers of normal implantation. It is likely that this thematic approach will facilitate the identification of newer biomarkers using microarray technology and inform the development of investigative paradigms using multiple markers at the time of presentation.

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“…Although the mechanisms underlying the functional roles of VEGF-A, PIGF, and ADAM12 in tubal EP are not clear, circulating levels of VEGF-A [12,18-23], PIGF [23-25], and ADAM12 [26-28] have been shown to change in women with EP. However, the retrospective case-control studies have yielded inconsistent results for such correlations [24,27,29]. The regulatory effects of changes in reproductive steroid hormones or of menstrual cycle phase on the circulating levels of VEGF-A, PIGF, and ADAM12 in women throughout normal intrauterine pregnancy (IUP) and post-term delivery are far less studied and understood.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the diagnostic values of circulating steroid hormones, VEGF-A, PIGF, and ADAM12 in women with ectopic pregnancy

Zou

Feng

et al. 2013

J Transl Med

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BackgroundSeveral peripheral proteins that might be useful for detecting the presence of ectopic pregnancy (EP) have been evaluated, but none have been proven entirely useful in the clinic. We investigated the presence and the possible changes in circulating molecules that distinguish between normal intrauterine pregnancy (IUP) and tubal ectopic pregnancy.MethodsNon-pregnant women during the menstrual cycle, women with IUP, and women with tubal EP after informed consent. Serum levels of 17β-estradiol (E2), progesterone (P4), testosterone (T), beta-human chorionic gonadotropin (β-hCG), vascular endothelial growth factor-A (VEGF-A), placental growth factor (PIGF), and a distintegrin and metalloprotease protein 12 (ADAM12) were analyzed. Receiver operating characteristic analysis was used to assess the diagnostic discrimination of EP and gestational age-matched IUP.ResultsE2, P4, PIGF, and ADAM12 levels increased and β-hCG decreased throughout IUP. E2 and VEGF-A levels were significantly different between women with tubal EP and IUP. However, using a serum β-hCG cut-off of less than 1000 mIU/mL, P4 was significantly lower in women with tubal EP compared to IUP. Although E2 was inversely correlated with VEGF-A in women in the early stages of IUP, E2 was not correlated with VEGF-A in women with EP prior to tubal surgery. There were no significant differences in either PIGF or ADAM12 alone between women with tubal EP or IUP. Although no significant correlations were seen between E2 and PIGF or P4 and ADAM12 in women in the early stages of IUP, E2 was positively correlated with PIGF and P4 was positively correlated with ADAM12 in women with EP prior to tubal surgery. Our studies defined associations but not causality.ConclusionsIndividual measurements of serum E2 or VEGF-A levels are strongly related to early pregnancy outcomes for women with IUP and EP, and pregnancy-associated E2 and VEGF-A levels provide diagnostic accuracy for the presence of tubal EP. This study demonstrates that correlation analysis of E2/VEGF-A and E2/PIGF serum levels may be able to distinguish a tubal EP from a normal IUP.

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Vascular endothelial growth factor (VEGF) and discrimination between abnormal intrauterine and ectopic pregnancy

Abstract: VEGF does not discriminate ectopic from abnormal intrauterine pregnancies at 6 weeks gestation, and thus should not be used in clinical management.

Cited by 19 publications

References 25 publications

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

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

Serum biomarkers of tubal ectopic pregnancy: current candidates and future possibilities

Comparison of the diagnostic values of circulating steroid hormones, VEGF-A, PIGF, and ADAM12 in women with ectopic pregnancy

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