Vascular Endothelial Growth Factor and β-human Chorionic Gonadotropin Are Associated with Trophoblastic Invasion into the Tubal Wall in Ectopic Pregnancy

Objective: To assess the association between the depth of trophoblastic penetration into the tubal wall with serum concentrations of vascular endothelial growth factor (VEGF) and β-hCG and to assess its predictive value.

Design: Prospective study.

Setting: Tertiary care university hospital.

Patient(s): Thirty patients with ampullary pregnancy undergoing salpingectomy were analyzed.

Intervention(s): Trophoblastic invasion was histologically classified as stage I when limited to the tubal mucosa, stage II when extending to the muscle layer, and stage III in the case of complete tubal wall infiltration.

Main Outcome Measure(s): The relation between depth of trophoblastic infiltration into the tubal wall with VEGF and β-hCG serum concentrations on the day of surgery.

Result(s): An association between the depth of trophoblastic invasion and maternal serum concentrations of VEGF and β-hCG was observed. VEGF levels of 297.2 pg/mL showed 100.0% sensitivity and 90.0% specificity for stage I, and levels of 440.1 pg/mL showed 81.8% sensitivity and 88.8% specificity for stage III. Beta-hCG levels of 2590.0 mIU/mL showed 88.9% sensitivity and 80.0% specificity for stage I, and levels of 10,827.0 mUI/mL showed 72.7% sensitivity and 88.9% specificity for stage III.

Conclusion(s): Maternal serum VEGF and β-hCG concentrations are associated with depth of trophoblastic penetration into the tubal wall.