The hormonal profile in ectopic pregnancies.

We prospectively investigated the maternal serum level of beta- human chorionic gonadotropin (beta-hCG) progesterone (P), estradiol (E2), human placental lactogen (HPL), alfa-fetoprotein (AFP) and cancer antigen 125 (CA 125) during the first trimester of normal and abnormal pregnancies. Serum samples were obtained from 20 women with normal intra-uterine pregnancy (IUPs). Fifteen whose pregnancies were complicated with spontaneous abortion and 31 with surgically and pathologically confirmed ectopic pregnancies (EPs). The mean serum levels of beta-hCG, E2 and P in patients with Eps (9490.55 +/- 3071.2 mIU/ml, 100.1 +/- 22.09 pg/ml, 4.18 +/- 1.19 ng/ml, respectively) were significantly lower than those measured in normal IUPs (73796.8 +/- 15554.7 mIU/ml, 500.15 +/- 98.84 pg/ml, 19.2 +/- 2.8 ng/ml respectively (p < 0.001) and significantly lower than in patients with spontaneous abortion (22524 +/- 6213 mIU/ml, p < 0.05, 339.8 +/- 112.16 pg/ml, p < 0.01, 10.59 +/- 3.03 ng/ml, p < 0.05 respectively). No significant difference was recorded with respect to serum levels of HPL, AFP and CA 125 among the groups. We also investigated the diagnostic value of simple E2 and P in patients with EPs. We could not identify a discriminatory cutoff value because there was a considerable overlap in serum P ans E2 levels between the patients with IUPs and EPs. In conclusion, it is not possible to define a cutoff discriminatory value of P and E2 that completely separates ectopic from IUPs, but the addition of these assays to the workup of a patient with suspected EP may facilitate the earlier diagnosis of EP.