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Chung and Moon: The predictive efficacy of maternal serum CA125 in intrauterine early pregnancy with vaginal bleeding
Original Article
Korean Journal of Obstetrics and Gynecology

Korean Journal of Obstetrics and Gynecology 2010; 53(6): 497-505.

Published online: 30 June 2010

DOI: https://doi.org/10.5468/kjog.2010.53.6.497

The predictive efficacy of maternal serum CA125 in intrauterine early pregnancy with vaginal bleeding

Ji Youn Chung, M.D., Chong Soo Moon, M.D.

Department of Obstetrics and Gynecology, Hallym University College of Medicine, Seoul, Korea.

Corresponding author (obgyn25@hallym.or.kr)

Received 21 April 2010       Accepted 20 May 2010

Copyright © 2010 Korean Society of Obstetrics and Gynecology

Abstract

Objective

To investigate whether sudden rise or already increased level of maternal serum CA125 predicts spontaneous abortion in early pregnancy with vaginal bleeding. And if so, to decide the CA125 cut-off level for poor pregnancy outcomes.

Methods

The prospective study was performed in forty women presenting with any vaginal bleeding at early pregnancy. Maternal serum CA125 levels were evaluated on the first visit and followed up during the first trimester, or until the time to diagnose abortion. Serial maternal serum β-hCG and ultrasonographic evaluation were also performed at the same time.

Results

There were eventually fourteen abortions and twenty-six ongoing pregnancies. Using receiver-operating characteristic curve, 150 U/mL of serum CA125 was the most useful value for predicting spontaneous abortion. In most of abortion women, the serum CA125 level was increased over than 150 U/mL immediately before the abortion. The twelve of 17 women who were 150 U/mL or more resulted in abortion, while there were just two cases of abortion among 23 women who were less than 150 U/mL. Its positive predictive value was 70.6% and negative predictive value was 91.3% respectively (P<0.01).

Conclusion

There was a strong correlation between high level of serum CA125 and subsequent spontaneous abortion in early pregnancy. It should be valuable to check maternal serum CA125 added to β-hCG and ultrasound for predicting pregnancy outcome at the early pregnancy, especially in the cases with vaginal bleeding.

Keywords: CA125, Prediction, Pregnancy outcome, Abortion

Figures and Tables

Figure 1
The difference of maternal serum CA125 levels between abortion and ongoing groups.
kjog-53-497-g001
Figure 2
Receiver-operating characteristic curve to determine CA125 cut off value predicting spontaneous abortion. AUC (area under the curve): 0.820. p<0.01.
kjog-53-497-g002
Figure 3
The Difference of maternal serum β-hCG levels between abortion and ongoing groups.
kjog-53-497-g003
Table 1
The characteristics of the study population
kjog-53-497-i001

Data are expressed as mean±standard deviation or median (range).

GA: gestational age.

Table 2
The results of maternal serum CA125
kjog-53-497-i002

Positive predictive value: 70.6%.

Negative predictive value: 91.3%.

*p<0.01

Table 3
The difference of G-sac diameter and CRL on vaginal ultrasonography between abortion and ongoing groups
kjog-53-497-i003

Data are expressed as means±standard deviation.

G-sac: gestational sac, CRL: crown rump length.

*p<0.01, †p<0.05.

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