ALGEIR T. RAKIM BSN111 N.

Diagnostic Biomarkers for Ectopic Pregnancy

Scientists at the University of Edinburgh’s Centre for Reproductive Biology have identified
novel biomarkers, present in the first trimester of pregnancy, for rapid identification of an
ectopic or extra-uterine pregnancy. A serum-based test is estimated to generate savings of up
to £1 million per year in Scotland alone.
There are approximately 12,000 ectopic pregnancy cases annually in the UK. However, no viable test
currently exists to distinguish an ectopic from a healthy pregnancy. It is estimated that nearly half of all
women are not diagnosed with the condition when they first seek medical attention, with 20% of
women needing up to five visits before it is detected.
Early accurate diagnosis would reduce the number of visits the patient has to make before treatment
(cost saving to medical providers) and avoid unnecessary invasive procedures and their inherent
dangers (better outcomes for patients). Naturally physicians are keen to conserve fallopian tubal
integrity, to facilitate less invasive medical management and to prevent potentially life-threatening
abdominal bleeding.
The Edinburgh biomarkers have been clinically validated (p<0.0005) in a study comparing three
patient groups - women undergoing (a) surgical termination of pregnancy, (b) uterine clearance after
miscarriage or (c) surgery for tubal ectopic pregnancy (n = 25). A 150 patient study is currently
underway.

Key Benefits
• Potential for rapid diagnosis of non-viable extra uterine pregnancies
• Reduces the risk of physiological and psychological damage to the patient
• Could be carried out in the form of a serum / blood test
• Savings of 1 million per year in Scotland
• Present in the first trimester of pregnancy

Applications
• GP surgeries
• Hospital laboratories

Publication Status
(a) Wedderburn CJ et al (2010) Human Reprod., 25: 328-333
(b) Horne AW et al (2009) Mol. Hum. Reprod., 15: 287-94
(c) Dalgetty DM et al (2008) Hum. Reprod., 23: 1485-90
(d) Horne AW (2008) J. Clin. Endocrinol. Metab., 93: 2375-82

Patent Status
A PCT patent application has been filed (Reference No. PCT/GB2008/002282) claiming priority from
2nd July 2007.
http://www.research-innovation.ed.ac.uk/records/opportunities/ectopicpregnancydiagnostic.asp
 SUMMARY
Ectopic pregnancy remains a considerable cause of maternal morbidity and mortality
worldwide. Currently, it is diagnosed using a combination of transvaginal ultrasound
and serial serum β-human chorionic gonadotrophin levels. Diagnosis is often delayed
and these tests are time-consuming and costly, both psychologically to the patient and
financially to health services. The development of a biomarker that can differentiate a
tubal ectopic from an intrauterine implantation is therefore important.
Early accurate diagnosis would reduce the number of visits the patient has to make
before treatment (cost saving to medical providers) and avoid unnecessary invasive
procedures and their inherent dangers (better outcomes for patients).the benefits
would be Potential for rapid diagnosis of nonviable extra uterine pregnancies
,Reduces the risk of physiological and psychological damage to the patient,and
Could be carried out in the form of a serum / blood test .

REACTION
Ectopic pregnancy can be a devastating experience: they are likely to be
recovering from major surgery; they have to cope with the loss of their baby and
often the loss of part of your fertility; and they may not have known they were
pregnant in the first place. That’s what happen to my patient don’t have the idea
what was it and thought it was an appendicitis or UTI.
they may feel utterly relieved to be free from the pain and profoundly grateful to
be alive, whilst at the same time be feeling desperately sad for their loss. The
sudden end to to pregnancy as what I have read will have left your hormones in
disarray, and this can make them feel depressed and extremely vulnerable.
The distress and disruption to family life resulting from the abrupt ending to a
pregnancy often combined with the need to recover from major surgery are not
difficult to imagine.
Before trying for another baby they should allow themselves time to recover
both physically and emotionally. . Feelings vary after the experience of ectopic
pregnancy: some women want to get pregnant again immediately, while others
are terrified at the thought and cannot cope with the stress of another anxious
pregnancy.
 ANECDOTAL

OBJECTIVES:
General: to be able to improve my skills and knowledge in taking care of patient
in ICU room
Specifically: to understand different cases of the patients inside the ICU room
: to be able to render my intervention in taking care of my patients
: to observe the actions of NOD to the patients
Time
6:30- circle time @ SPMC GYNE WARD
7:00- endorsement time
7:30- start of our rounds and distribution of patients
8:00- I started my Vital sign taking with my two patients
9-10-11- monitored my patient
12:00pm- lunch time
1-2- went back to my patient and did my work
3pm- charting(plotting) end of duty

Learning’s,weakness and recommendation

I was excited and was much more organized than yesterday wherein I was
late and considered absent. one of my weaknesses having a hard time
waking up in the morning as I im not use to it. This day I was really
conscious of safety aspects because of the client's unstable vital signs, I
noticed that her IVF line is not patent and tried to make it work but it
doesn’t seems to work so I called our C.I to assist and Help me and end up
nothing but to removing it. I was the one who did the KSS. Patient got
edeme at the site of the infusion. What I did was I pat face towel soak with
warm water to reduce the swelling by the virtue of vasodilation. I was also
shocked when my patient became weird I mean she looked very ill to the
point she have to receive oxygen. It was challenging though. Our CI
thought us a lot of things which we haven’t taken during our lecture time. It
was my first time to have duty in the gyne (ICU). I have seen a lot of
procedures such as removing catheter, feeding through NGT and first action
when there is sign of shock. I cannot ask for more because during the duty I
was fully contented and satisfied with everything.