Serum Angiopoietin-1 & Angiopoietin-2 as Serum Biomarkers for Ectopic Pregnancy and Missed Miscarriage
Keywords:Angiopoietin-1 , Angiopoietin-2, Ectopic Pregnancy, Missed Miscarriage
Background: The angiopoietins are proteins which belong to the family of angiogenic proteins,
Angiopoietin-1 (Ang-1) and (Ang -2) are two critical regulators with different functions of vascular
development and angiogenesis indicators for placental growth and maternal vascular health in early
pregnancy and miscarriage .
Objective: To evaluate whether a single serum measurement of angiopoietin-1 and angiopoietin-2 at 6-8
weeks gestation can differentiate failed pregnancies, whether ectopic pregnancies or missed miscarriages,
from healthy intrauterine pregnancies.
Methods: This study was a case control study conducted at Obstetric & Gynecological Department of
Baghdad Teaching hospital /Medical city through the period from 1 st of March to end of August, 2017
Patient and method: the study included 93 pregnant women as following:
a- 33 women with intrauterine viable pregnancy
b- 30 pregnant women diagnosed as first trimester miscarriage.
c- 30 women with ectopic pregnancy( proved by histopathology)
Full history was taken and clinical examination was done blood sampling was performed ,full routine
investigation ( complete blood picture , renal and liver indices ,blood group ) and measurement of angiopoietin
1 and 2 levels and B.HCG were taken.
Results: Mean angiopoitin-1 and angiopoitin-2 levels was significantly lower among women with
ectopic pregnancy (p<;0.001), in same way, there was a highly significant reduction in angiopoitin-1 and
angiopoitin-2 mean among women with miscarriage than healthy women (p<0.001).
Angiopoietin ratio was significantly lower among women with ectopic
Pregnancy (p<0.001). Validity results of angiopoitin-2 in prediction of ectopic pregnancy and miscarriage in
early pregnancy were better than angiopoitin-1 and human chorionic gonadotropins ratio titre. Angioepoitin
1&2was not significant in differentiation between ectopic pregnancy and missed miscarriages (p=0.5).