The value of vascular endothelial growth factor, pregnancy-associated plasma protein-A, and progesterone for early differentiation of ectopic pregnancies, normal intrauterine pregnancies, and spontaneous miscarriages

ObjectiveTo evaluate the capacity of vascular endothelial growth factor (VEGF), pregnancy-associated plasma protein-A (PAPP-A), and progesterone (P) to discriminate ectopic pregnancies (EP) from nonectopic ones.DesignProspective, case-controlled study.SettingTertiary care center.Patient(s)Twenty-nine women with EP, 29 women with normal intrauterine pregnancy (nIUP), and 28 women with spontaneous miscarriage, all matched for gestational age.Intervention(s)Serum samples were obtained.Main Outcome Measure(s)Serum concentrations of VEGF, PAPP-A, and P were measured.Result(s)Serum VEGF concentrations did not show statistically significant differences among women with EP (median, 55.24 pg/mL; range, 0.20–179.24), spontaneous miscarriages (median, 26.24 pg/mL; range, 0.22–365.24), and nIUP (median, 43.24 pg/mL; range, 0.86–101.24). The median level of P was significantly increased in the nIUP group (20.58 ng/mL; range, 13.9–37.04) compared with the other two groups, but there was no statistically significant difference between the spontaneous miscarriage and EP groups. Like P, PAPP-A values were also significantly higher in the nIUP group than in the other two groups, but the difference between PAPP-A values in the EP and spontaneous abortion groups was statistically insignificant.Conclusion(s)VEGF, PAPP-A, and P cannot be used to diagnose EPs, but PAPP-A and P can at least be used to differentiate abnormal pregnancies.