CPK: The new tool in the diagnosis of ectopic pregnancy

Suvarna Jyothi Ganta, Sunanda R. Kulkarni, Vidya Muralidhar


Background: Ectopic pregnancy is still a diagnostic dilemma presenting with various complaints. The classic triad of amenorrhea, abdominal pain, vaginal bleeding and /or syncope is not always seen. Misdiagnosis can lead to delay in treatment, blood loss is found to be the major cause of death. Early and accurate diagnosis is critical in bringing down the maternal mortality and morbidity. Prompt and effective treatment of an ectopic pregnancy can help preserve the chances of future healthy pregnancies. Aim of present study was to investigate whether creatinine phosphokinase (cpk) can be used as an effective diagnostic tool in the early diagnosis of ectopic pregnancy which can help in decreasing the maternal mortality and morbidity

Methods: This observational comparative three group clinical study was conducted at Chinmaya Mission Hospital, Bangalore, between May 2016 to January 2017.120 women in their early trimester were studied of which 40 were diagnosed cases of ectopic pregnancies, 40 women presented with intrauterine abortive pregnancies and 40 women had normal healthy pregnancies. Serum CPK, serum B-HCG, vaginal scans were done in all, along with routine investigations.

Results: The mean CPK values in normal, abortive and ectopic pregnancies were 36.92±6.44, 43.95±11.96 and 91.55±30.43 respectively. It was found to be significantly higher in ectopic Pregnancies. Also, the mean CPK in ruptured and unruptured ectopic pregnancy were 97.26±25.97 and 63.82±34.92 respectively.

Conclusions: Present study shows that maternal CPK levels are significantly higher in women with ectopic pregnancies. CPK can serve as the reliable biochemical marker to diagnose ectopic pregnancy particularly ruptured. CPK can be used to increase the diagnostic efficacy in ectopic pregnancy, which followed by rapid and appropriate treatment can reduce the mortality, morbidity and preserve future fertility.


Abortive pregnancy, B-hCG, CPK, Diagnostic tool, Ectopic pregnancy

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Virkud A. Modern Obstetrics. 2nd ed, APC publishers; chapter 7:63.

Cunningham, leveno, Bloom, Williams OBS, 24th ed. Mc graw Hill; chapter 19:377-8.

Lott JA, Abott LB. Creatine kinase isoenzyme. Clin Lab Med. 1986;6(3):547-76.

Lavie O, Beller U, Neuman M, Ben-Chetrit A, Gottcshalk-Sabag S, Diamant YZ. Maternal serum creatine kinase a possible predictor of tubal pregnancy. Am J Obstet Gynaecol. 1993;169:1149-50.

Chandra L, Jain A. Maternal serum creatine kinase as a diagnostic marker for tubal pregnancy. Int J Gynaecol Obstet. 1995;49(1):21-3.

Saha PK, Gupta I, Ganguly NK. Evaluation of serum creatine kinase as a diagnostic marker for tubal pregnancy. Aust NZJ Obstet Gynaecol. 1999;39:366-7.

Kurzel RB, Mazdisnian F, Paige S, Liu P. Serum creatine kinase is not a reliable indicator of ectopic pregnancy. Int J Fertil Women’s Med. 2001;46(6):300-3.

Chhabra S, Aher K, Jaiswal M. Clinical study of ectopic pregnancy. Indian J Metrn Child health. 1992;3(4):118-21.

Houry De, Salhi BA, Acute complications of pregnancy. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier; 2009:176.

Shetty S, Shetty A. A clinical Study of Ectopic Pregnancies in a Tertiary care hospital of Mangalore, India. Innovative J Med Health Sci. 2014;4(1):305-9.

Gupta R, Porwal S, Swarnkar M, Sharma N, Maheshwari P. Incidence, trends and risk factors for Ectopic Pregnancies in a tertiary care hospital of Rajasthan. JPBMS. 2012;16(16):16.

Shafi S, Beigh M, Jan S. Reliability of maternal serum creatine kinase in diagnosis of tubal pregnancy. IOSR-JDMS. 2016;15(4):26-31.

Maryam, Faraji R, MIrblouk F, Roshan ZA, Parvizi A. Evaluation of serum creatine phosphokinase in diagnostic of tubal ectopic pregnancy compared with intrauterine pregnancy and threatened abortion. Iran J Reprod Med. 2012;10(4):303-6.

Mohammad AA, Ahmad HF, Effat DM, El-sayed Z. The role of creatine phosphokinase and B-hcg in the early diagnosis of ectopic pregnancy. Nat Sci. 2012;10(11):225-30.

Abdullateef HA. serum creatine kinase and its isoenzymes CK-MB in the prediction of tubal ectopic pregnancy. Iraqi J Med Sci. 2013;11(2):170-5.