Abstract

ROLE OF TOTAL SERUM CREATINE KINASE IN DIAGNOSIS OF TUBAL PREGNANCY

*Ayver Mohamed Mahmood, Mahmood Sami Wafeeq MBCHB. HDLO, Khulood Tahseen Mahdi

ABSTRACT

Background: Vaginal sonograghy and serial -hCG are the most common diagnostic methods for ectopic pregnancy, however about 50% of cases are initially misdiagnosed. In tubal pregnancy the zygote lies next to the muscular layer and this invasion supposed to causes an increase in creatine phosphokinase (CPK) in blood. Objective: To evaluate the role of total serum creatine kinase (ck) as a biochemical marker in the diagnosis of ruptured tubal pregnancy. Patient and Material: A prospective study done in Al-Zahraa Teaching Hospital at Al-Najaf city /Iraq which attached to Medical College Kufa University in conducted from 20ty April to 1st September 2016. The study recruited 100 pregnant women between 20-45 years old with no significant difference for age between groups. The studied groups include 25 women with ectopic pregnancies 25, missed abortion & fifty women intrauterine pregnancy were taken as control group, serum levels of total Creatine Kinase in three groups were measured and compared. Women with a history of heart disease, nervous system disease, thyroid disease and myopathy were excluded. A through history was taken were and physical examination were done along with investigation including B-HCG, CR and ultrasonography. The venous blood was taken for serum CK estimation before any invasive procedure. The sample kept at freezing -4C and the work done at 37◦C, by human manual kit for CK. The device used is spectrophotometer. Normal range of serum total CK in female is 167 u/l according to the International Federation of Clinical Chemistry (IFCC), the upper reference limit of CK in adults is determined by the 97.5th percentile at the standard temperature of 37° C. Results: Total serum Creatine Kinace was not significantly higher in tubal pregnancy compared to other groups. Sensitivity=72%, Specificity=65.3%, Positive predictive value=40.9%, which indicate creatine kinace is poor test for diagnosis ectopic pregnancy. Conclusion: Our conclusion in this study is that the measurement of total Creatine Kinace has low sensitivity and low specificity in diagnosing the tubal pregnancy alone.

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