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Single serum activin a testing to predict ectopic pregnancy.

Pasquale Florio1, Filiberto Maria Severi, Caterina Bocchi

  • 1Chair of Obstetrics and Gynecology, Department of Pediatrics, Obstetrics and Reproductive Medicine, University of Siena, Policlinico Le Scotte, viale Bracci, 53100 Siena, Italy.

The Journal of Clinical Endocrinology and Metabolism
|March 8, 2007
PubMed
Summary

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Activin A measurement shows high accuracy in diagnosing ectopic pregnancy (EP). This biomarker can identify women at risk of EP with 100% sensitivity and 99.6% specificity, aiding early detection.

Area of Science:

  • Reproductive Endocrinology
  • Maternal-Fetal Medicine
  • Clinical Chemistry

Background:

  • Ectopic pregnancy (EP) is a leading cause of early pregnancy mortality, often due to diagnostic delays.
  • Accurate and timely diagnosis is crucial for effective management and improved maternal outcomes.

Purpose of the Study:

  • To evaluate the diagnostic utility of activin A levels for ectopic pregnancy detection.
  • To compare activin A with human chorionic gonadotropin (hCG) and progesterone in diagnosing EP.

Main Methods:

  • An open observational study involving 536 women with suspected EP.
  • Measurements included clinical examination, ultrasound, hCG, progesterone, activin A, and histological examination.

Main Results:

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  • Activin A levels were significantly lower in EP compared to spontaneous abortion (SAB) and intrauterine pregnancies (IUP).
  • Activin A demonstrated 100% sensitivity and 99.6% specificity for EP detection at a cutoff of 0.37 ng/ml.
  • A positive predictive value of 97.43% was observed for EP when activin A concentrations were below the cutoff.

Conclusions:

  • Activin A is a highly sensitive and specific biomarker for diagnosing ectopic pregnancy.
  • Measurement of activin A can significantly improve the early detection of EP, potentially reducing maternal mortality.