RESUMO
Prompt diagnosis of ectopic pregnancy is a difficult dilemma, and reliable predictors for diagnosis and differentiation of ectopic pregnancy from early pregnancy miscarriage are needed. To evaluate the diagnostic value of serum progesterone and CA-125 levels in ectopic pregnancy and early intra uterine miscarriage. A prospective case control study. The study was carried out in the department of obstetrics and gynecology of AL-Yarmouk teaching hospital [Baghdad - Iraq] from February 2011 to February 2012. This study was carried out on sixty pregnant women in their first trimester. Twenty women diagnosed as unruptured ectopic pregnancy; treated by laparotomy, twenty women diagnosed as inevitable miscarriage; treated by curettage and twenty women with healthy pregnancy of a comparable gestational age as control group; follow up of this group was done to ascertain uneventful pregnancy with no complications. We compared the serum levels of progesterone and CA-125 in all groups at the time of presentation and 24h after surgical intervention in first and second groups. There was a significant decrease in mean post operative progesterone level in women with ectopic pregnancy and miscarriage groups with significant difference [P<0.0001]. The study observed that the mean level of progesterone in women with ectopic group [6.76 +/- 3.63 ng/ml] was lower than that in miscarriage group [15.17 +/- 6.01 ng/ml] and control group [17.58 +/- 4.57 ng/ml] with significant difference [P<0.0001]. This study also observed that the mean level of CA-125 in women with miscarriage group [117.07 +/- 94.30 U/ml] was higher than that in ectopic group [38.11 +/- 28.79 U/ml] and control group [30.51 +/- 16.10 U/ml] with statistically significant difference [P<0.0001]. There was a significant decrease in mean level of post operative CA-125 in women with ectopic pregnancy and miscarriage groups with significant difference [P<0.0003]. Combined measurement of both serum progesterone and CA-125 can be sensitive predictors in diagnosis and differentiation of ectopic pregnancy from inevitable miscarriage and normal pregnancy