Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions

Abstract

Background: Although CA125 is a valuable tumor marker of ovarian carcinoma but it may be have a value to assess the risk of miscarriage at the early stages of pregnancy for woman with history of recurrent pregnancy loss either alone or in combination with other biochemical marker. Objective: To predict pregnancy outcome by studying the level of serum β HCG, progesterone and CA125 at different gestational age in the first trimester for predicting pregnancy loss. Patient and Methods: This study was conducted in Al-Batool Teaching Hospital (in the center of Diyala governorate by studying the patient records as a prospective trail in period from Jan. 2010 to Jan. 2011. The study carried out on 90 pregnant women with a history of recurrent pregnancy loss in there first trimester of pregnancy divided in 3 groups (30 women with no history of abortion as control group, 30 women with history of recurrent pregnancy loss, 30 women who failed to complete their pregnancy in the first trimester during the study. Serial maternal B-HCG, progesterone and CA125 were determined. Results: Serum B-HCG showed a sensitivity of 97%, a specificity of 53%, a PPV (positive predictive value) of 56% and a NPV (negative predictive value) of 97%. Serum progesterone showed a sensitivity of 27%, a specificity of 79%, a PPV of 38% and a NPV of 69%, while serum CA125 showed a sensitivity of 8%, a specificity of 60%, a PPV of 10% and a NPV of 70%. Conclusion: the value of CA125 in recurrent abortions is still unclear and cannot be recommended on routine basis. On the other hand, β-HCG is 97% sensitive with a 53% NPV as a single serum measurement for the prediction of pregnancy outcome.