• Logo
  • SBMUJournals

Creatine phosphokinase, a new marker in diagnosis of tubal ectopic pregnancy; A Systematic Review

Maryam Ghorbani, Afsaneh keramat, Farideh Mohsenzadeh Ledari
83

Views


Abstract

Introduction: Creatine phosphokinase (CPK) is an intracellular enzyme found in higher levels in the brain, myocardium, soft muscle and skeletal muscle, as well as the fallopian tube. This review was conducted to evaluate the role of serum CPK in early diagnosis of tubal ectopic pregnancy (EP). 

Methods: We performed an electronic literature search in Web of Science, Scopus, Embase and Medline databases and manual search in Google scholar and evaluated papers from the beginning of 1990 to September 2018. The inclusion criteria consisted of cohort, case-control and diagnostic value studies in English or Persian. Two independent researchers used the inclusion and exclusion criteria. In cases where there was doubt about the eligibility of studies, this problem was resolved by consulting a third researcher. After a thorough search, finally, we found 27 papers.  However, four of these articles did not have the inclusion criteria and we excluded them from the study. As a result, 24 studies were evaluated.

Results: Most studies have approved the use of CPK measurements in EP diagnosis. The main variable measured in most studies was the mean total CPK level. However, there is limited knowledge about the efficacy of measuring CPK levels in EP diagnosis; this review of studies shows positive results regarding use of CPK in EP diagnosis.

Conclusions: The results highlighted the potential benefits of CPK as a marker for early diagnosis of EP.


Keywords

Pregnancy, ectopic; early diagnosis; creatine kinase; biomarkers

References

Saadati N, Najafian M, Masihi S, Safiary S, Abedi P. Comparison of two different protocols of methotrexate therapy in medical management of ectopic pregnancy. Iranian Red Crescent Medical Journal. 2015;17(12).

Asgharnia M, Faraji R, Mirblouk F, Roshan ZA, Parvizi A. Evaluation of serum creatine phosphokinase in diagnosis of tubal ectopic pregnancy compared with intrauterine pregnancy and threatened abortion. Iranian journal of reproductive medicine. 2012;10(4):303.

Ghelichkhani P, Yousefifard M, Nazemi L, Safari S, Hosseini M, Baikpour M, et al. The value of serum β-subunit of human chorionic gonadotropin level in prediction of treatment response to methotrexate in management of ectopic pregnancy; a systematic review and meta-analysis. International Journal of Pediatrics. 2016;4(9):3503-18.

Soundravally R, Latha MTK, Raghavan SS, Ananthanarayanan P, Srilatha K. Diagnostic significance of total creatine kinase and its isoform in tubal. Minerva Ginecol. 2010;62:49-62.

Cabar FR, Fettback PB, Pereira PP, Zugaib M. Serum markers in the diagnosis of tubal pregnancy. Clinics. 2008;63(5):701-8.

Develioglu OH, Askalli C, Uncu G, Samli B, Daragenli O. Evaluation of serum creatine kinase in ectopic pregnancy with reference to tubal status and histopathology. BJOG: An International Journal of Obstetrics & Gynaecology. 2002;109(2):121-8.

Shafi S, Beigh M, Jan S. Reliability of Maternal Serum Creatine Kinase in Diagnosis of Tubal Pregnancy.

Kruchkovich J, Orvieto R, Fytlovich S, Lavie O, Anteby EY, Gemer O. The role of CPK isoenzymes in predicting extrauterine early pregnancy. Archives of gynecology and obstetrics. 2012;286(1):135-7.

Lavie O, Beller U, Neuman M, Ben-Chetrit A, Gottcshalk-Sabag S, Diamant YZ. Maternal serum creatine kinase: a possible predictor of tubal pregnancy. American journal of obstetrics and gynecology. 1993;169(5):1149-50.

Duncan W, Sweeting V, Cawood P, Illingworth P. Measurement of creatine kinase activity and diagnosis of ectopic pregnancy. BJOG: An International Journal of Obstetrics & Gynaecology. 1995;102(3):233-7.

Chandra A, Martinez GM, Mosher WD, Abma JC, Jones J. Fertility, family planning, and reproductive health of US women; data from the 2002 National Survey of Family Growth. 2005.

Darai E, Vlastos G, Benifla JL, Sitbon D, Hassid J, Dehoux M, et al. Is maternal serum creatine kinase actually a marker for early diagnosis of ectopic pregnancy? European Journal of Obstetrics & Gynecology and Reproductive Biology. 1996;68:25-7.

Lincoln SR, Dockery JR, Long CA, Rock WA, Cowan BD. Maternal serum creatine kinase does not predict tubal pregnancy. Journal of assisted reproduction and genetics. 1996;13(9):702-4.

Korhonen J, Alfthan H, Stenman U-H, Ylöstalo P. Failure of creatine kinase to predict ectopic pregnancy. Fertility and sterility. 1996;65(5):922-4.

Zorn J-R, Cherruau B, Abi-Rached F, Dehée A, Danoy X, Le Blond J, et al. Evaluation of maternal plasma creatine kinase activity as a marker of abnormal early pregnancy. Human reproduction. 1997;12(11):2534-7.

Plewa MC, Ledrick D, Buderer NF, King RW. Serum creatine kinase is an unreliable predictor of ectopic pregnancy. Academic emergency medicine. 1998;5(4):300-3.

Vitoratos N, Gregoriou O, Papadias C, Konidaris S, Kalogirou D, Kalampokis D, et al. Clinical value of creatinine kinase in the diagnosis of ectopic pregnancy. Gynecologic and obstetric investigation. 1998;46(2):80-3.

Saha P, Gupta I, Ganguly N. Evaluation of serum creatine kinase as a diagnostic marker for tubal pregnancy. Australian and New Zealand journal of obstetrics and gynaecology. 1999;39(3):366-7.

Spitzer M, Pinto AB, Dasgupta R, Benjamin F. Early diagnosis of ectopic pregnancy: can we do it accurately using a biochemical profile? Journal of women's health & gender-based medicine. 2000;9(5):537-44.

Birkhahn RH, Gaeta TJ, Leo PJ, Bove JJ. The utility of maternal creatine kinase in the evaluation of ectopic pregnancy. The American journal of emergency medicine. 2000;18(6):695-7.

Birkhahn RH, Gaeta TJ, Paraschiv D, Bove JJ, Suzuki T, Katoh H, et al. Serum levels of myoglobin, creatine phosphokinase, and smooth muscle heavy-chain myosin in patients with ectopic pregnancy. Annals of emergency medicine. 2001;38(6):628-32.

Katsikis I, Rousso D, Farmakiotis D, Kourtis A, Diamanti-Kandarakis E, Zournatzi-Koiou V, et al. Creatine phosphokinase in ectopic pregnancy revisited: significant diagnostic value of its MB and MM isoenzyme fractions. American journal of obstetrics and gynecology. 2006;194(1):86-91.

Wazir S, Yasmeen S, Prarveen S, Nisar S, Parveen S, Chesti S, et al. Reliability of Maternal Serum Creatinine Phosphokinase (CPK) in The Diagnosis of Ectopic Pregnancy. 2009.

Kh E, SD S. The Value of Serum Creatine Phosphokinase for Diagnosis of Ectopic Pregnancy. ZUMS Journal. 2013;21(86):97-104.

Ghahiri A, Moshreffar A, Najafian A, Ghasemi M, Tehrani HG. Assessment of the diagnostic capability of serum creatine phosphokinase and its isoenzyme in ectopic pregnancy. International journal of fertility & sterility. 2012;6(3):185.

Abdullateef HA. Serum Creatine Kinase and its Isoenzyme CK-MB in the Prediction of Tubal Ectopic Pregnancy. Iraqi Journal of Medical Sciences. 2013;11(2):170-5.

Suvarna Jyothi Ganta SRK, Vidya Muralidhar. CPK: The new tool in the diagnosis of ectopic pregnancy. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(6):2507-11.

Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Human reproduction update. 2013;20(2):250-61.

Van Mello N, Mol F, Opmeer B, Ankum W, Barnhart K, Coomarasamy A, et al. Diagnostic value of serum hCG on the outcome of pregnancy of unknown location: a systematic review and meta-analysis. Human reproduction update. 2012;18(6):603-17.




DOI: https://doi.org/10.22037/aaem.v8i1.501

DOI (PDF): https://doi.org/10.22037/aaem.v8i1.501.g698

DOI (HTML): https://doi.org/10.22037/aaem.v8i1.501.g724