Authors
1
Martyr Dhari al- Fayad Hospital, Al-Husseiniya, Baghdad, Iraq
2
Gynecology and Obstetrics, retired professor
Abstract
BACKGROUND:
Ectopic pregnancy causes major maternal morbidity and mortality. Human Placental growth hormone shows a non-pulsatile secretion pattern and short serum half-life making it of major advantage compared to the standard marker human chorionic gonadotropin.
OBJECTIVE:
To evaluate the clinical implication of serum human placental growth hormone variant and immunohistochemistry as a possible biomarker for the course of ectopic pregnancy.
PATIENTS AND METHODS:
This is a cross sectional study carried out in the department of Obstetrics and Gynecology of Al- Yarmouk Teaching Hospital for the period from January 2020 to October 2020, It includes 50 pregnant women in first trimester with confirmed ectopic pregnancy, maternal serum β -human chorionic gonadotrophin titer was measured and human placental growth hormone variant level was analyzed for each patient using enzyme-linked immunosorbent assay and tissue specimen were taken from serum human placental growth hormone variant negative and positive cases and examined by immunohistochemistry.
RESULTS:
Serum human placental growth hormone variant was shown to be positive in 28 cases of ectopic pregnancy and negative in 22 cases, β-human chorionic gonadotropin levels were significantly higher in the serum of the patient with human placental growth hormone variant positive group (p-value = 0.001).
Serum human placental growth hormone variant was positive in all specimens of cases examined by immunohistochemistry even in serum negative cases.
CONCLUSION:
Human Placental growth hormone was shown to be present both in serum and tissue of ectopic pregnancy patients. Its short half-life makes it of a great clinical advantage as a biomarker for ectopic pregnancy course and monitoring response to treatment.
- Madhra M, Horne AW, Ectopic pregnancy. Arulkumaran S, Ledger W, Denny L, Doumouchtsis S. In: Oxford textbook of obstetrics and gynecology.1st E. Oxford University Press.2020;39:489-98.
- Celso Silva and Anita Patel. Miscarriage and ectopic pregnancy. Errol R. Norwitz, Carolyn M. Zelop, David A. Miller, and David L. Keefe. In: Evidence-Based Obstetrics and Gynecology, First Edition. John Wiley & Sons Ltd. 2019; 4:33-42.
- Kho RM, Lobo RA. Ectopic Pregnancy Etiology, Pathology, Diagnosis, Management, Fertility Prognosis. Lobo RA, Gershenson DM, Lentz GM, Valea FA. In: Comprehensive Gynecology.7th E. Elsevier.2017;17:348-69.
- Padubidri VG. Ectopic gestation. Padubidri VG, Shirish N Daftary. In: Shaw’s Textbook of Gynecology. 16th E. Elsevier. 2015; 21:293-310.
- Hübener C, Bidlingmaier M, Wu Z, Diebold J, Strasburger CJ, Mahner S, Hasbargen U, Delius M. Human placental growth hormone in ectopic pregnancy: Detection in maternal blood, immunohistochemistry and potential clinical implication. Growth Hormone & IGF Research. 2017; 37:13-8.
- Panelli DM, Phillips CH, Brady PC. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: a review. Fertility Research and Practice. 2015;1:15.
- Li H, Liu Y, Wen S, Jia H, Du Y. Evaluation of serum biomarkers and efficacy of MTX in women with ectopic pregnancy. Molecular medicine reports. 2019;20:2902-8.
- Liao S, Vickers MH, Stanley JL, Baker PN, Perry JK. Human placental growth hormone variant in pathological pregnancies. Endocrinology. 2018;159:2186-98.
- Velegrakis A, Sfakiotaki M, Sifakis S. Human placental growth hormone in normal and abnormal fetal growth. Biomedical reports. 2017;7:115-22.
- Chard, T. Richard Lilford. Cell Biology, Embryology and the Placent. In: basic science for obstetrics and gynecology.5th E.1998;1;1-36.
- Fuglsang J, Ovesen P. Aspects of placental growth hormone physiology. Growth hormone & IGF research. 2006;16:67-85.
- Asah‐Opoku K, Oppong SA, Ameme DK, Nuamah MA, Mumuni K, Yeboah AO, Ndanu TA, Nkyekyer K. Risk factors for ectopic pregnancy among pregnant women attending a tertiary healthcare facility in Accra, Ghana. International Journal of Gynecology & Obstetrics. 2019;147:120-25.
- Gaskins AJ, Missmer SA, Rich-Edwards JW, Williams PL, Souter I, Chavarro JE. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertility and sterility. 2018 ;110:1328-37.
- Arslan S, Tuncay G, Aytan H, Tapisiz OL. Serum β-hCG level: can it discriminate between unruptured and ruptured tubal ectopic pregnancies? 2004;9
- Helmy S, Mavrelos D, Sawyer E, Ben-Nagi J, Koch M, Day A, Jurkovic D. Serum human chorionic gonadotropin (β-hCG) clearance curves in women with successfully Expectantly managed tubal ectopic pregnancies: a retrospective cohort study. PloS one. 2015;10: e0130598.
- Dhar H, Hamdi I, Rathi B. Methotrexate treatment of ectopic pregnancy: experience at Nizwa hospital with literature review. Oman Medical Journal. 2011;26:94.
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