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  • Title: Serum activin A does not predict ectopic pregnancy as a single measurement test, alone or as part of a multi-marker panel including progesterone and hCG.
    Author: Warrick J, Gronowski A, Moffett C, Zhao Q, Bishop E, Woodworth A.
    Journal: Clin Chim Acta; 2012 Apr 11; 413(7-8):707-11. PubMed ID: 22245044.
    Abstract:
    BACKGROUND: To evaluate the diagnostic accuracy of activin A alone or in a multi-marker panel for the prediction of ectopic pregnancy (EP). METHODS: A retrospective analysis was performed on a cohort of 289 women who presented to the emergency department (ED) with vaginal bleeding and/or abdominal pain/cramping and were diagnosed with EP, spontaneous abortion, or viable intrauterine pregnancy. Serum progesterone, hCG, and activin A concentrations were measured on the samples obtained in the ED. Statistical analysis was performed to determine the clinical utility of these biomarkers as single measurement and as a multi-marker panel test for ectopic pregnancy. Women ≥18 y with vaginal bleeding or abdominal pain/cramping. RESULTS: Progesterone (<10 ng/ml), hCG (<6,699 IU/l), and activin A (<0.26 ng/ml) cutoffs were optimized by ROC analysis. These demonstrated sensitivities of 62.9%, 74.2%, and 59.6%, and specificities of 60.5%, and 63.0%, and 61.0% respectively for detecting EP. The multi-marker panel utilizing all three biomarkers had a sensitivity of 70% and specificity of 69%. CONCLUSION: Serum activin A cannot be used as a single measurement or in a multi-marker panel with progesterone and hCG to predict EP.
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