Abstract
Diagnosis of ectopic pregnancy relies on both ultrasound findings and human chorionic gonadotropin (hCG) measurements but due to the need for serial tests, tubal rupture and death represent major maternal and fetal risks. Early detection of ectopic pregnancy is essential and thus a noninvasive diagnostic tool seems crucial for the prevention of adverse effects since studies suggest there is a specific relationship between ectopic pregnancy and increasing microRNA factors. Human fluids in women with ectopic pregnancy reveal a particular change in comparison to healthy women. In addition to certain placental microRNAs circulating through plasma that present a specific concentration and serum profile, microRNAs seem to be possible biomarkers for the detection of pregnancy complications linked to placental pathologies. The aim of this study is to review current literature considering the expression levels of several circulating microRNAs that have shown to be novel potential biomarkers for the diagnosis of tubal ectopic pregnancy.
Highlights
BackgroundAn ectopic pregnancy (EP) is a pregnancy in which a fertilized ovum is implanted outside the uterine cavity with over 98% of the implantation in the fallopian tube
The exact pathophysiology of EP is still unknown, it is firmly believed that retention of the embryo within the Fallopian tube due to impaired embryo-tubal transport combined to alterations in the tubal environment, lead to early implantation
Diagnosis of EP relies on a combination of transvaginal ultrasonographic, serum human chorionic gonadotropin and progesterone, due to the poor clinical utility for early detection, the development of a new, noninvasive serum test to diagnose EP with high sensitivity and specificity becomes mandatory in order to prevent both EP and the upcoming life-threatening complications, and avoid unnecessary surgical or medical management that may interrupt a potentially viable pregnancy or affect patients’ fertility
Summary
An ectopic pregnancy (EP) is a pregnancy in which a fertilized ovum is implanted outside the uterine cavity with over 98% of the implantation in the fallopian tube. In seven to nine weeks of gestation, an increase was detected as it concerns the normal early pregnancies that was not observed in ectopic pregnancies at this age of gestation Until this research, this marker was identified only in plasma, and data of this effort cast doubts about the placental origin in ectopic pregnancies of the mir-32-3p levels, with authors supporting a non-embryonic origin of mir-32-3 while further investigation is proposed, in order to fully clarify the usefulness of this miRNA as marker in ectopic pregnancy [38]. They show how irregular regulation of the specific and distinctive miRNA targets neural precursor cell expressed developmentally downregulated protein 4 (NEDD4), TATA binding associated factor 15 (TAF15), and spen family transcriptional repressor (SPEN), might contribute to the onset of tubal pregnancy. The authors suggested miR-873 as a single, noninvasive and stable marker for early EP detection [46]
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