Is serum creatine kinase a reliable indicator for early diagnosis of ectopic pregnancy?

Abstract

Background: To determine the sensitivity of serum creatine kinase level in diagnosis of unruptured ectopic pregnancy. Methods: This descriptive prospective case control study was performed in Alzahra and Taleghani teaching hospitals in Tabriz Iran from 2006 to 2008 on 88 women with ectopic pregnancy (44 case of ruptured and 44 case of unruptured ectopic pregnancy). The control group was consisted of 44 women with normal intrauterine pregnancy. The serum cretine kinase level was measured by Eliza method in blood samples. Results: the results were compared by variance analysis and t-test. SPSS.14 statistical software were used for analyzing the data. By determining cut-off level of 45 Iu/L the specificity and sensitivity was estimated. The mean of creatine kinase level was 48.24آ±14.97 iu/l in intrauterine pregnancy and 54.40آ±20.40 iu/l and 87.00آ±45.42 iu/l in unruptured and ruptured ectopic pregnancies, respectively. The difference in creatine kinase level between ectopic pregnancy and normal intrauterine pregnancy was significant (p=0.001). The difference between serum creatine kinase level in rupture and unrupture ectopic pregnancy also was significant p=0.04. Creatine kinase levels above 45u/l was 65% sensitive and 79% specific for diagnosis of ectopic pregnancy from intrauterine pregnancy and 78% sensitive and 84% specific for diagnosis of unruptured ectopic pregnancy from ruptured ectopic pregnancy. Conclusions: Transvaginal sonography and quantitative bHCG measurment are the optimal and most effective strategy for diagnosis of ectopic pregnancy.