Evaluation of serum inhibin A as a surveillance marker after conservative management of tubal pregnancy
| Autor: | Euan M. Wallace, Philip Jm Lowe, Pam Mamers, D. D’Antona, Nick D Balazs, Nigel P. Groome |
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| Rok vydání: | 1998 |
| Předmět: |
Adult
endocrine system medicine.medical_specialty Inhibin a Time Factors endocrine system diseases Conservative management medicine.drug_class Chorionic Gonadotropin Gynecologic Surgical Procedures Pregnancy Placenta medicine Humans Inhibins Salpingostomy reproductive and urinary physiology Gynecology Ectopic pregnancy business.industry Rehabilitation Obstetrics and Gynecology Trophoblast medicine.disease female genital diseases and pregnancy complications medicine.anatomical_structure Reproductive Medicine Methotrexate Female Laparoscopy Pregnancy Tubal Gonadotropin business hormones hormone substitutes and hormone antagonists Biomarkers medicine.drug |
| Zdroj: | Monash University |
| ISSN: | 0268-1161 |
| Popis: | Tubal pregnancy is now commonly managed by laparoscopic salpingostomy or systemic methotrexate. A disadvantage of such conservative management is the need for appropriate follow-up, with serial measurement of serum concentrations of human chorionic gonadotrophin (HCG), to exclude persistent ectopic pregnancy (PEP). Concentrations of inhibin A, also a placental product, are significantly increased during pregnancy and the half-life of inhibin A is significantly shorter than that of HCG. To assess the suitability of inhibin A as a marker of PEP, we studied 16 women who had undergone surgery for a tubal pregnancy, measuring HCG and inhibin during follow-up. The mean +/- SEM time taken to achieve non-pregnant concentrations of inhibin A was significantly shorter than for HCG (4.2 +/- 0.8 days versus 21.6 +/- 4.4 days respectively; P < 0.001 Wilcoxon signed rank test). However, in all women the inhibin A concentration increased rapidly after reaching a nadir, reflecting the return of ovarian function, complicating the interpretation of results. In four women inhibin A was almost undetectable preoperatively, while the corresponding HCG concentration was high. These data suggest that inhibin A will not be a useful marker for PEP but that it may provide a more accurate preoperative assessment of trophoblast viability than HCG, thereby improving management. |
| Databáze: | OpenAIRE |
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