ABSTRACT
Background: The aim of this study was to evaluate the relationship between ultrasonographic findings and serum progesterone and cancer antigen-125 [CA-125] levels in threatened miscar-riage and to predict pregnancy outcome
Materials and Methods: In a prospective comparative case-control study, serum CA-125 and progesterone levels were measured for 100 pregnant women with threatened miscarriage who attended the outpatient clinic or the causality department of Obstetrics and Gynecology at Kasr El-Aini Hospital, Giza, Egypt, during the period from March 2013 to October 2013. Ultrasound was performed for fetal viability, crown-rump length [CRL], gestational sac diameter [GSD] and fetal heart rate [FHR]. The patients were followed up and divided into two groups based on the outcome: 20 women who miscarried [group 1], and 80 women who continued pregnancy [group 2]. The sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], and overall accuracy were tested for CA-125 and progesterone levels in prediction of the pregnancy outcome. Correlation of these chemical markers with the ultrasound markers was also examined
Results: In the group that miscarried, CA-125 level was significantly higher [P<0.001] and serum progesterone level was significantly lower [P<0.001]. For prediction of the outcome of pregnancy, the cut-off limit of 31.2 IU/ml for CA-125 level yielded sensitivity, specificity and an overall accuracy of 96.2, 100 and 99.4% respectively. The cut-off limit of 11.5 ng/ml for progesterone level yielded sensitivity, specificity and an overall accuracy of 97.5, 100 and 99.8% respectively. CA-125 level had a negative correlation with progesterone level and FHR levels [r=-0.716, P<0.001] and [r=-0.414, P<0.001] respectively. Serum progesterone level correlated with GSD [r=0.521, P<0.001] and with CRL [r=0.407, P<0.001] and FHR [r=0.363, P<0.001]. CA-125 level was significantly higher in the group that showed hematoma as compared with the group without hematoma [P<0.001]. Also, serum progesterone level was significantly lower in the group that showed hematoma as compared with the group without hematoma [P=0.017]
Conclusion: Serum CA-125 and progesterone levels are valid early predictors of the outcome of pregnancy in women with threatened miscarriage. They are correlated with some ultrasonographic markers [GSD, CRL, and FHR]