Publication:

Comparison of maternal serum CA-125 and ultrasonography findings as a prognostic marker in threatened abortion

Background WHO defines abortion as pregnancy termination before 20 week gestation or with fetus born weighing <500 gms. Early pregnancy markers in patients with threatened abortion including biochemical marker like raised maternal serum CA-125 (cancer antigen-125, carcinoma antigen 125 or carbohydrate antigen 125) and USG parameters that is, fetal crown-rump length (CRL), the presence/absence of sub-chorionic hematoma and fetal heart rate (FHR) are good predictors of outcome.

Methods The study was conducted in the department of obstetrics and gynaecology, S.P. medical college and associated group of hospital, Bikaner, Rajasthan. This was a hospital based prospective comparative study. The study group comprise of pregnant females attending obstetrics and gynaecology OPD. A total of 200 pregnant women were examined in this study. We divided these patients into 2 groups, group A and group B. Group A consists of 100 pregnant females with threatened abortion and group B with 100 normal pregnant female.

Results Maternal serum CA-125 at cut off level 61.64 U/ml is 84.21% sensitive, 96.77% specific in predicting abortion with 94.12% positive predictive value and 90.91% negative predictive value while FHR at 115 bpm is 76.32% sensitive, 90.32% specific in predicting abortion with 82.86% PPV and 86.15% negative predictive value.

Conclusions Single raised value of maternal serum CA-125 has best predictive value followed by USG parameters (FHR, sub-chorionic hematoma and CRL ) in threatened abortion which results in loss of pregnancy.