{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:09:27Z","timestamp":1767848967382,"version":"3.49.0"},"reference-count":30,"publisher":"The Endocrine Society","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Context: Ectopic pregnancy (EP) is an important cause of maternal deaths in early pregnancy because most fatal cases result from delayed diagnosis and inappropriate investigation.<\/jats:p>\n               <jats:p>Objective: We evaluated whether the measurement of activin A may be useful in the diagnosis of EP in women with unknown pregnancy location.<\/jats:p>\n               <jats:p>Design: The study was designed as an open observational study.<\/jats:p>\n               <jats:p>Setting: The study was set in a tertiary referral center for obstetric care.<\/jats:p>\n               <jats:p>Patients: Patients were women with unknown pregnancy location (n = 536) who had complaints of bleeding, pain, or cramping.<\/jats:p>\n               <jats:p>Interventions: Interventions included clinical examination; transvaginal ultrasound scan; human chorionic gonadotropin (hCG), progesterone, and activin A measurements; laparoscopy; uterine curettage; and histological examination.<\/jats:p>\n               <jats:p>Main Outcome Measures: Main outcome measures were pregnancy outcomes and evaluation of sensitivity, specificity, and predictive values of hCG, progesterone, and activin A as diagnostic tests for the detection of EP.<\/jats:p>\n               <jats:p>Results: Pregnancy outcomes included 155 (28.9%) viable intrauterine pregnancies (IUP), 305 (56.9%) first-trimester spontaneous abortion (SAB), and 76 (14.2%) EP. SAB had the lowest (P &amp;lt; 0.0001) hCG and progesterone concentrations, significantly lower than EP (P &amp;lt; 0.001) and IUP (P &amp;lt; 0.001). In EP, levels were significantly (P &amp;lt; 0.001) lower than in IUP. On the contrary, activin A levels were lowest (P &amp;lt; 0.0001) in EP, significantly lower than in SAB (P &amp;lt; 0.001) and IUP (P &amp;lt; 0.001). IUP had significantly (P &amp;lt; 0.001) lower activin A levels than SAB. When evaluated by the receiver operating curve analysis, activin A at the cutoff of 0.37 ng\/ml combined a sensitivity and a specificity of 100 and 99.6%, respectively, for prediction of EP. When activin A concentrations were below the cutoff, the positive predictive value for EP was 97.43%, and 0% for concentrations higher than 0.37 ng\/ml.<\/jats:p>\n               <jats:p>Conclusions: Activin A measurement may identify patients at risk of EP with a high sensibility and specificity.<\/jats:p>","DOI":"10.1210\/jc.2006-2188","type":"journal-article","created":{"date-parts":[[2007,3,7]],"date-time":"2007-03-07T03:01:53Z","timestamp":1173236513000},"page":"1748-1753","source":"Crossref","is-referenced-by-count":50,"title":["Single Serum Activin A Testing to Predict Ectopic Pregnancy"],"prefix":"10.1210","volume":"92","author":[{"given":"Pasquale","family":"Florio","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filiberto Maria","family":"Severi","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Bocchi","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Luisi","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Mazzini","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology, Department of Paediatrics, Obstetrics and Reproductive Medicine, University of Siena, 53100 Siena, 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