Keywords : Ectopic Pregnancy


Evaluation of Maternal Serum Ischemia Modified Albumin in Ectopic Pregnancy

Alaa Nadhim Hameed; Ayla Khether Ghalib

Iraqi Postgraduate Medical Journal, 2021, Volume 20, Issue 1, Pages 8-16
DOI: 10.52573/ipmj.2021.167820

BACKGROUND:
An ectopic pregnancy is defined as the implantation of a pregnancy outside the normal uterine cavity. Serum ischemia-modified albumin (IMA) and adjusted IMA appear to be significantly increased during pathological pregnancies.
AIM OF THE STUDY:
To compare the level of IMA in ectopic and normal pregnancies, thus understanding the association between oxidative stress and the incidence of ectopic pregnancy.
METHODS:
A case-control study that included 80 women; 38 of them with ectopic pregnancy, and the other 42 were healthy pregnant women. Patients with systemic diseases, a history of smoking, the use of antiinflammatory drugs and antioxidants were excluded from the study. Serum IMA was measured using enzyme-linked immunosorbent assay (ELISA) for all participants.
RESULTS:
Means of IMA and adjusted IMA in women with ectopic pregnancy were significantly higher than that in women with normal pregnancy.
CONCLUSION:
There is an association between oxidative stress and ectopic pregnancy

The Role of Homocysteine and CA125 in the Differentiation between Ectopic Pregnancy and Spontaneous Abortion in First Trimester

Iraqi Postgraduate Medical Journal, 2020, Volume 19, Issue 2, Pages 156-164

ABSTRACT:
BACKGROUND:
Ectopic pregnancy and spontaneous abortion are the two common complications seen in early
pregnancy. While spontaneous abortion is the most common complication of pregnancy, ectopic
pregnancy is the most life threatening emergency in early pregnancy.
OBJECTIVE:
To investigate the diagnostic value of serum homocysteine and CA-125 levels for early diagnosis
and differentiation for early pregnancy complications.
PATIENTS AND METHODS:
The study included 90 pregnant women, aged from 21 to 40 years old presented with a gestational
age ranging between 5-13 weeks. The patients were divided into three groups, group A included 30
cases of ectopic pregnancies, group B Included 30 cases who presented with spontaneous abortions
and group C included 30 cases who presented as normal uncomplicated pregnancies and were
followed up till their normal term deliveries and was considered as the control group. All women in
the studied groups underwent CA125 and serum homocysteine measurements by radioimmune assay
and Enzyme-linked immunosorbent assay (ELISA) respectively.
RESULTS:
Regarding group A, the majority of cases had low levels of serum homocysteine on admission (60%)
and only one case changed from low to high level after one week from surgical termination of
pregnancy. The CA125 readings were subdivided into two subdivisions: the first subdivision was the
ruptured ectopic pregnancy cases on admission and diagnosis and they were 20 out of the 30 cases
of ectopic pregnancy, half of these cases (50%) had high CA125 levels on admission and 3 patients
had returned to normal after one week from surgical termination of pregnancy, in the second
subdivision (unruptured ectopic pregnancies which were10 cases), the vast majority of patients
(90%) had normal CA125 levels on admission and all of them had returned to normal after one week
from the surgical termination of pregnancy. Regarding group B, (56.7%) of patients had high levels
of serum homocysteine on admission and none of them had returned to normal value after one week
from spontaneous or interventional completeness of the abortion, while the results of CA125 showed
that (63.3%) of patients had high levels of this tumor marker on admission and 6 cases had returned
to normal levels after one week from spontaneous or interventional completeness of the abortion.
In group C, the majority of the cases were within normal ranges of both CA125 and serum
homocysteine both at admission and one week follow up. (90% and 93.3% regarding CA125) and
(76.6% and 70% regarding serum homocysteine).
CONCLUSION:
The measurement of serum homocysteine and CA125 was found to be an effective method for early
diagnosis and differentiation between spontaneous abortion and ectopic pregnancy.

Role of Serum Progesterone in the Diagnosis of Ectopic Pregnancy and Missed Abortion

Abdulrazak H Alnakash; Zeina Abdulsahib

Iraqi Postgraduate Medical Journal, 2015, Volume 14, Issue 1, Pages 22-27

ABSTRACT:
BACKGROUND:
diagnosis of early pregnancy failure (ectopic pregnancy and missed abortion) still challenging even by using of serial B-HCG and ultrasound. Serum progesterone hormone level value is regarded as one of the important diagnostic tools in the diagnosis of many obstetrical and gynecological conditions; one of these is early pregnancy failure.
OBJECTIVE:
To assess the role of serum progesterone level in early diagnosis of ectopic pregnancy and missed abortion.
PATIENTS AND METHODS:
The study is conducted at Al-Elwiyah Maternity Teaching Hospital throughout the period between (April 2010 –July 2011). Ninety women participated in the study, they are at their early weeks of gestation (6-10) weeks. Their ages were between 18-40 years. thirty of them served as a control group (normal intrauterine pregnancy) and sixty pregnant women included in the study group and subcategorized into 2 groups. thirty women with suspected sub-acute or chronic cases of ectopic pregnancy according to ultrasound and β-HCG results and 30 women served as suspected missed abortion. blood samples were taken from the three groups followed by another blood samples after two-day interval to measure of serum progesterone levels. the results were compared among the three groups at first and second readings. p-value, standard deviation and 95% confidence interval calculated and statistically analyzed.
RESULTS:
P-value of the serial measurements of serum progesterone levels in two-day interval in the three groups was statistically insignificant. while serum progesterone levels of both ectopic pregnancy and missed abortion were greatly lower than serum progesterone levels of normal intrauterine pregnancy in both first and second readings, with statistically significant
deference, P-value is
CONCLUSION:
Serum progesterone levels has a useful role in diagnosing ectopic pregnancy and missed abortion.

Serum CA-125 in Ectopic Pregnancy

Lilyan W. Sersam; Rasha Shakir Mahmood

Iraqi Postgraduate Medical Journal, 2013, Volume 12, Issue 3, Pages 343-350

ABSTRACT:
BACKGROUND:
CA-125 is a glycoprotein, its origin is uncertain during pregnancy. It rises during the first trimester and
returns to a non-pregnancy range in late pregnancy.
OBJECTIVE:
To compare CA-125 levels between tubal ectopic and normal intrauterine pregnancy, and to find it’s
usefulness in differentiating intact from ruptured tubal ectopic pregnancy.
METHODS:
This prospective case-control study was carried out on sixty healthy women with single normal
intrauterine pregnancy (NIUP) of 6-10 weeks gestation and sixty women with tubal ectopic pregnancy
of same gestational age which were further subdivided into twenty-five women with ruptured tubal
ectopic pregnancy (REP) and thirty-five women with unruptured tubal ectopic pregnancy (UREP). The
levels of CA-125 were compared between these groups.
RESULTS:
The mean level of CA-125 in ruptured ectopic pregnancy group was 49.04±33.63 IU/ml and in
unruptured ectopic pregnancy group was 24.3±16.89 IU/ml. The mean level of CA-125 in normal
pregnant women (control group) was 53.95±31.2 IU/ml. There was a statistically significant difference
between mean serum CA-125 levels of ruptured ectopic pregnancy and unruptured ectopic pregnancy
group (p< 0.05), also there was a statistically significant difference between mean of CA-125 level of
unruptured ectopic pregnancy group and control group (p <0.05), while there was no statistically
significant difference between ruptured ectopic pregnancy group and control group (p > 0.05).
CONCLUSION:
CA-125 level is significantly elevated in ruptured tubal ectopic pregnancy than the intact tubal ectopic
pregnancy, this increase in CA-125 levels can be used as additional test to identify tubal rupture