Serum kisspeptin, to discriminate between ectopic pregnancy, miscarriage and first trimester pregnancy

The present study aimed to determine serum kisspeptin levels which is an emergent marker regarding trophoblastic invasion, in patients with different types of early pregnancy. We also aimed to investigate whether kisspeptin can be used for differential diagnosis of ectopic pregnancy or miscarriage from early pregnancy. This was a prospective case-control study that was conducted at a tertiary centre of obstetrics and gynaecology. Four groups of women (81 patients) enrolled in the study: group 1, women with ectopic pregnancy (n = 17); group 2, women with miscarriage (n = 23); group 3, women with healthy pregnancy at first trimester (n = 21); and group 4, healthy non-pregnant women (n = 18). Serum kisspeptin levels were found as 0.30 (0.22-0.40), 0.11 (0.08-0.16), 1.48 (1.29-1.80), and 0.03 (0.01-0.04) ng/mL in ectopic, miscarriage, healthy pregnancy and non-pregnant groups, respectively (p< .001). A moderate correlation was seen between serum kisspeptin levels and human chorionic gonadotropin (β-hCG) (r= 0.51, p< .001). Our data showed that for the first time that a single serum kisspeptin level may be used to discriminate ectopic pregnancy or miscarriage from healthy pregnancy at early weeks' gestation. In addition, serum kisspeptin levels of the patients with ectopic pregnancy were found higher significantly than the patients with miscarriage.Impact StatementWhat is already known on this subject? Definite diagnosis of abnormal or abnormal pregnancies at first trimester is based on hCG levels and ultrasonography. Kisspeptin, a neuropeptide was investigated in normal pregnancies and found to be increased in trophoblastic invasion.What do the results of this study add? Serum kisspeptin levels in patients with normal pregnancy were found more higher than patients with ectopic or miscarriage at early weeks of gestation (p < .001). The women with ectopic pregnancy have higher kisspeptin levels than the women with miscarriage (p < .001).What are the implications of these findings for clinical practice and/or further research? These findings can be used to make differential diagnosis between abnormal and normal early pregnancies. In future studies with more sample size, serum or plasma kisspeptin levels in early weeks of gestation can be investigated.