The role of D-dimer with beta-human chorionic gonadotropin, progesterone and cancer antigen-125 as markers for miscarriage

Abstract

Background/Aim Miscarriage is defined as pregnancy termination before the 20th week of gestation or if a baby’s birth weight is more than 500 g. Approximately 10–12% of all gestations worldwide end with a miscarriage. We aimed in this study to evaluate the role of serum level of D-dimer along with beta-human chorionic gonadotropin (β-HCG), progesterone, and cancer antigen-125 (CA-125) in the prediction of first trimetric miscarriage. Patients and methods A total of 400 pregnant women from the Centre of Excellency Clinic, National Research Centre, Egypt, were recruited in this study at the fifth week of gestational age. Patients were divided into two groups: group 1 included patients whose pregnancy was completed (n=356), and group 2 included patients who had miscarriage (n=44). Serum level of D-dimer was measured by enzyme-linked fluorescence assay, whereas serum levels of β-HCG, progesterone, and CA-125 were measured by using an enzyme-linked immunosorbent assay technique at the fifth week and 13th week of gestation for all participants, and then they underwent follow-up until 20 weeks of pregnancy. Results Pregnancy was completed in 356 women (group 1), whereas miscarriage occurred in 44 women (group 2). At the fifth week and 13th week of gestation, the serum level of D-dimer in the fifth week was insignificant, but it became significant in the 13th week. β-HCG and progesterone were found significantly lower, whereas the level of CA-125 was found higher in women who aborted (group 2). Conclusion During the first trimester, maternal serum markers such as D-dimer with β-HCG, progesterone, and CA-125 levels represent early, noninvasive techniques to predict miscarriage.