Abstract
Objective To assess the clinical value of serum CA125 for predicting pregnancy outcome. Methods This prospective observational study enrolled 160 threatened abortion patients (threatened abortion group), 105 non-threatened abortion pregnant women (control group) and 40 non-pregnant normal women (non-pregnant group) who were admitted to the Gynecology Department of Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2016 to May 2018. According to ultrasonography with or without subchorionichematoma (SCH), the threatened abortion group was divided into SCH+ group (n=65) and SCH- group (n=95). All pregnant women were followed up until 12 weeks of gestation. According to the pregnancy outcome, the threatened abortion group was divided into symptomatic abortion subgroup (54 cases of abortion outcome) and ongoing pregnancy subgroup (106 cases of ongoing pregnancy). Control group was divided into 45 cases without clinical symptoms which ultrasound indicated embryo abortion (no symptom abortion subgroup) and 60 cases with normal pregnancy (normal subgroup). Serum CA125 levels were measured at the gestational age between 6-9 weeks or follicular phase in non-pregnant women by electro-chemiluminescence. The differences of serum CA125 levels in each group were compared and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of CA125 for pregnancy outcomes. Results The CA125 level in normal pregnancy subgroup [(40.37±17.80) IU/mL] was significantly higher than that in non-pregnant group [(15.82±7.07) IU/mL] (P=0.001). The CA125 levels were significantly higher in symptomatic abortion subgroup [(96.20±60.05) IU/mL] than in normal group and ongoing pregnancy subgroup [(39.74±19.08) IU/mL] (P<0.001). The CA125 level in the asymptomatic abortion subgroup [(20.05±9.52) IU/mL] was significantly lower than that in normal group and ongoing group (P<0.001). The CA125 level was significantly higher in SCH+ group [66.16(37.19,95.64) IU/mL] as compared with the SCH- group [27.98(15.43,52.75) IU/mL] (P<0.001). The pregnancy outcome of patients with threatened abortion was poor when CA125≥54.19 IU/mL at 6-9 weeks. The sensitivity, specificity and area under curve (AUC) were 83.4%, 78.4% and 0.86 respectively. For threatened abortion patients in early pregnancy, the pregnancy outcomes were poor when CA125≤18.82 IU/mL at 6-9 weeks. The sensitivity, specificity and AUC were 96.0%, 65.8% and 0.87 respectively. Conclusion Maternal serum levels of CA125 was higher during the first trimester of normal pregancy. Both too high or too low is not conducive to the process of pregnancy. It can be useful to reflect the extent of decidual destruction or the defective decidual development which is directly related to the outcome of pregnancy. CA125 is valid early predictors of the outcome of pregnancy. Key words: CA125; Spontaneous abortion; Subchorionichematoma; Pregnancy outcome
Published Version
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