Evaluation of plasma creatine phosphokinase (CPK) level following a single injection of methotrexate as a predicator of treatment success in ectopic pregnancy

Aleyasin, A.; Safdarian, L.; Aghahosseini, M.; Sarvi, F.; Hosseini Musa, S.; Kohbody, M.; Najafian, A.; Gharajeh, S.
June 2014
Iranian Journal of Reproductive Medicine;Jun2014 Supplement, Vol. 12, p11
Academic Journal
Introduction: To evaluate the plasma creatine phosphokinase (CPK) level after a single injection of methotrexate (MTX) as a predictor of treatment success in ectopic pregnancy (EP). Materials and Methods: In this prospective study, 79 women >18 years treated with methotrexate for EP were evaluated for CPK and β-subunit of human chorionic gonadotropin (βhCG) levels, while they received intramuscular MTX at a dose of 50 mg/m2. The day of injection was considered as day 1 (D1). CPK on D1 was compared between the group 1 (as treatment success group), treated by a single MTX injection, and the group 2, treated by two or three MTX injections or by surgery. Results: The success rate of MTX treatment was 58 (73.3%). The mean of CPK was higher in groupl than failure group (group 2) (71.98±15.711 vs. 64.43±15.898), but the difference wasn't significant (p=0.06). The mean of βhCG was significantly lower in group 1 than group 2 (1187.52±631.45 vs. 1663.87±1096.845; p=0.01). Ultrasonographic findings of EP were seen in 63 patients, while the means of βHCG and CPK were higher in these patients than those with normal ultrasonography, but difference wasn't significant (p=0.37, p=0.24, respectively). Conclusion: The sample wasn't large enough to indicate a significant difference in the CPK, which can be considered as an indicator for differentiating between group 1 and group 2. This study didn't show any relation between initial β-hCG and CPK levels, so our findings indicate that they aren't possibly considered as two independent biomarkers in EP.


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