Evaluation of maternal plasma creatine kinase activity as a marker of abnormal early pregnancy |
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Authors: | Zorn JR; Cherruau B; Abi-Rached F; Dehee A; Danoy X; Le Blond J; Ekindjian O |
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Institution: | Clinique Universitaire Baudelocque et Service de Biochimie A, Hopital Cochin, Paris, France. |
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Abstract: | We have tested the value of maternal plasma creatine kinase activity for
diagnosing ectopic pregnancies obtained after in-vitro fertilization and
embryo transfer. Plasma creatine kinase was assayed in 57 patients: 20
normal, 23 miscarriages and 14 ectopic pregnancies, for a total of 240
samples. All values were in the lower part of the normal range except only
one in a miscarrying patient. A statistically significant difference was
observed for a cut-off value of 45 IU/l between normal and ectopic
pregnancies. However, for this cut-off point, the measurement of plasma
creatine kinase activity had a sensitivity of 0.50 and a specificity of
0.76 for the diagnosis of ectopic pregnancy. The positive predictive value
was 0.69. Creatine kinase activity measurements are thus of no practical
value in this particular population, in which an early and specific marker
of ectopic implantation would be of paramount interest. The association of
human chorionic gonadotrophin (HCG) determinations and ultrasound scanning
of the pelvis still remain the best paraclinical support for an early
diagnosis of ectopic implantation.
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