Evaluation of potential diagnostic markers of ectopic pregnancy An Indian study

Abstract

Ectopic pregnancy is the implantation of the fertilized ovum outside the intrauterine cavity It is the leading cause of maternal mortality and morbidity during the first trimester around the globe and leads to intraabdominal hemorrhage and impairs future fertility of the woman This research aimed to study the potential diagnostic biomarkers of Ectopic pregnancy This case control study was performed with 140 cases of EP and 140 controls of normal pregnant women at Sri Ramachandra Medical College Hospital Chennai Total Beta hCG and Progesterone were assayed by chemiluminescence soluble fms like tyrosine kinase 1 by ELISA and relative quantification of miRs by Reverse Transcription PCR analysis Total and#946;hCG has a sensitivity of 31 point 4 percent and specificity of 100 percent at a cut off value of less than 1616 mIU/mL which is near the clinically used discriminatory zone. Progesterone had a better sensitivity of 94 point 3 percent and specificity of 93 point 6 at a cut off value less than 14 point 4 ng/mL but its usage as a single biomarker has however been negated by the recent NICE guidelines of 2019 Of the 8 miRs evaluated in sera of women with EP in this study Four miRs were differentially down regulated has miRs 141218 519d and 873 and four miRs were differentially up regulated has miRs 223 517a 523 and 323 3p As an individual marker sFLT 1 at a cut off value less than 634 pg/mL has a very good sensitivity of 98 point 6 percent and specificity of 90 percent. MiR 519d appears to be a promising potential biomarker with highest specificity of 97 point 1 percent, sensitivity of 47 point 1 percent and expression fold change of 0 point 46 Furthermore the combination of sFLT 1 with miR 519d also improved the sensitivity to 100 percent with a good specificity of 87 point 1 percent newline