MATERNAL SERUM ALPHA-FETOPROTEIN LEVELS IN ECTOPIC PREGNANCIES - A PROSPECTIVE, CONTROLLED-STUDY

Objective: To compare the serum alpha-fetoprotein (AFP) levels from wo men with intrauterine pregnancies to those with ectopic pregnancies. M ethods: Serum samples were obtained from 25 patients with ectopic preg nancies and 23 patients with intrauterine pregnancies. All ectopic pre gnancies were located in the fallopian tube and were proven by patholo gy specimens obtained at laparotomy or laparoscopy. The ectopic pregna ncy group was further divided into ruptured and unruptured tubal pregn ancies as determined at the time of surgery. The age, gravidity, parit y, estimated gestational age, and the AFP values of the control group were compared with those of the ruptured and unruptured ectopic groups . Analysis of variance was applied and a P value of less-than-or-equal -to 0.05 was considered to be significant. Results: The elevation of A FP in the entire ectopic group nearly reached significance (P = 0.0502 ) as compared with controls. This difference appeared to be related to patients with ruptured ectopics which were found to have a significan t elevation (P < 0.025) in AFP values when compared with intrauterine gestation controls. No significant difference was found between contro ls and those patients with unruptured ectopics. Conclusions: In the ab sence of rupture, AFP values are more likely to be within the normal r ange for early gestation. Though normal AFP values do not reliably rul e out the presence of early tubal ectopic pregnancy, elevated AFP leve ls may indicate extensive tubal trophoblastic invasion associated with frank or impending ectopic pregnancy rupture.