Clinical Value of a Single Serum CA-125 Level in Women with Symptoms of Imminent Abortion during the First Trimester of Pregnancy

OBJECTIVE: To assess the clinical value of a single serum CA-125 level in women presenting with symptoms of imminent abortion from 5 to 12 weeks' gestation. STUDY DESIGN: Two hundred women with symptoms of imminent abortion from 5 to 12 weeks' gestation were allocated to 3 subgroups: group I (n = 50), abdominal pain only; group II (n = 80), abdominal pain and vaginal bleeding of less than 3 days duration; and group III (n = 70), abdominal pain and vaginal bleeding of ≥ 3 days' duration. The control group (n = 55) was women undergoing a normal pregnancy of comparable gestational age. In all patients, CA 125 and β-human chorionic gonadotropin (β-hCG) levels were determined with commercially available enzymatic immunoassay tests. RESULTS: A significant increase in serum CA-125 levels was observed in patients with vaginal bleeding (groups II and III) in comparison with the control group. In contrast to CA-125, serum β-hCG levels were significantly lower in patients who went on to miscarry. Receiver operating characteristic curve analysis revealed that all women with symptoms of imminent abortion who have a CA-125 level of ≥ 43.1 U/mL should be considered as having a greater risk of miscarriage. Patients with bleeding of ≥ 3 days should have a threshold value of 66.5 U/mL applied as a risk determinant. CONCLUSION: A single, serum CA-125 level determination is valuable in women with imminent abortion presenting with abdominal pain, vaginal bleeding or both.