Value of a single serum CA-125 in the prediction of miscarriage in women presenting with first trimester abortion

ABSTRACT

CA-125 levels are raised during all processes involving decidual activity [early pregnancy, immediately after birth and bleeding episodes during pregnancy]. In this study we investigated the usefulness of determining maternal single serum levels of CA-125 in maternal serum as a predictor of the fate of the bleeding episode in women presenting with first trimester abortion. The study is a prospective controlled study. Inclusion criteria including vaginal spotting, transvaginal ultrasound evidence of living intrauterine embryo or fetus, monovular pregnancy, normal ovaries seen by ultrasound and gestational age between 6-12 weeks. Exclusion criteria are multiple pregnancy, ovarian masses and pelvic endometriosis. Our study included 95 pregnant patients in their first trimester of pregnancy [40 patients [42.2%] in the abortion group who actually terminated their conceptions, 30 patients [31.5%] in the recovery group who successfully overcame the bleeding episode and continued their pregnancy, and 25 patients [26.3%] as a control group, who have no bleeding]. Our results showed that the abortion group tends to have a significantly lower duration of conception than the other two groups. As regards CA-125 levels, the p value was 0.00 for recovery vs. abortion groups [highly significant], 0.0006 [highly significant] for recovery vs. control groups, and 0.00 for abortion vs. control groups [highly significant]. The test yielded a sensitivity of 93.33% and a specificity of 95.38%. Such results lead to the conclusion that determination of CA-125 level in maternal serum during a bleeding episode in the first trimester of pregnancy has a significant predictive ability as regards the outcome of pregnancy