Pregnancy-associated plasma protein A in pregnancy-related gynaecologic emergency

Serum concentrations of pregnancy-associated plasma protein A (PAPP-A) were measured in patients with pregnancy-related gynaecologic emergencies including ectopic pregnancy (n = 124) and intrauterine abortion (n = 40). The results were compared with those in normal pregnancy (n = 136) and non-pregnant women (n = 460). In ectopic pregnancy and intrauterine abortion, the PAPP-A levels were lower than in normal pregnancy. In patients with a pregnancy-related gynaecologic emergency PAPP-A was undetectable in 82% of the ectopic pregnancies and in 55% of the intrauterine abortions. Considering the frequency of ectopic pregnancy (35.8%) and intrauterine abortion (52.3%) among all patients with pregnancy-related disorders, the likelihood that a pregnant patient with undectable PAPP-A has an ectopic pregnancy is 30%, and intrauterine abortion is 29%. These results indicate that although PAPP-A levels in ectopic pregnancy and intrauterine abortion are lower than in normal pregnancy, PAPP-A measurement cannot be used to distinguish between ectopic pregnancy and intrauterine abortion.