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SERUM CANCER ANTIGEN 125(CA125) IN THREATENED MISCARRIAGE AND NORMAL PREGNANCY.
Abstract
Background:
Spontaneous miscarriage is a common early pregnancy complication, often times, a significant cause of psychological and emotional burden to patients. To the best of my knowledge, there is paucity of studies on prediction of pregnancy outcome in patients with threatened miscarriages in Nigeria. This study compared levels of maternal serum CA125 in pregnancies with threatened miscarriages and that of normal intrauterine pregnancy between gestational ages 6 weeks and 19weeks + 6 days.
Methodology:
Sixty-five women with threatened miscarriage (cases) and 65 women with normal ongoing intrauterine pregnancies (controls) were studied. Whole blood samples were collected at presentation for estimation of CA125 by the enzyme linked immunosorbent assay (ELISA) technique. Ultrasound scan confirmation of fetal heart activity was also done and the cases were treated appropriately. Statistical analysis was done using SPSS version 17 software package.
Results:
The age range of all participants was 20 to 40 years, with mean value of 30.5 ± 0.38 years. The mean maternal age for cases was 29.5± 0.14 years and 30.1±0.14 years for controls. Mean parity for cases was 1.1 ± 0.08 and 0.91 ± 0.08 for controls. The mean gestational age for cases was 10.3 ± 0.65 weeks and for controls, it was 12.1 ± 0.65 weeks. There was no statistically significant difference between maternal age, parity and gestational age between cases and controls. The mean serum CA125 among cases was 30.1±1.1iu/ml and 22.9±1.2 iu/ml among the controls. This was found to be statistically significant, p value 0.0001. Serum CA125 level among final aborters (cases who finally aborted) was also found to be higher than in non aborters (cases who carried pregnancy to term) with levels of 34.8 ±1.4 iu/ml and 27.3± 1.2iu/ml respectively. This was also found to be statistically significant with p value 0.001. Further analysis using CA125 concentration of >36.2iu/ml (mean value of CA125 in aborters + 1 S.D) as a threshold for intrauterine pregnancies that eventually got aborted showed a sensitivity of 66.7%, specificity of 83.3%, positive predictive value of 55.6% and negative predictive value of 88.9%.
Conclusion:
The measurement of CA125 is a useful predictor of pregnancy outcome in threatened miscarriages. From this study, it can be deduced that serum CA125 has a diagnostic potential for predicting women with symptoms of threatened miscarriage who will eventually miscarry. However, larger studies are recommended to give a universally acceptable cut off value for serum CA125 and also to assess its routine use in the prediction of pregnancy outcome in women with threatened miscarriage.
