CA125, progesterone & β-hCG in prediction of first trimester abortion

Introduction

Pregnancy loss is a common medical problem in reproductive-age as more than fifty percent of human pregnancies are aborted before term. The majority are unrecognized occurring before or with the expected next menses. About 10–12 percent of all clinically diagnosed pregnancies are lost as first-trimester or early second trimester. The rate of fetal death after 14 weeks’ gestation is much lower than the rate of pre-embryonic and embryonic loss. CA125 is a member of the mucin family glycoproteins. CA125 has found application as a tumor marker or biomarker that its level may be increased in the serum of some patients with specific types of cancers. Some studies detected that the abortion risk is increased in pregnant women with higher CA125 levels. Progesterone belongs to the C21 group of progestogen. Its main source in humans is the corpus luteum.

Human chorionic gonadotropin (HCG) is a glycoprotein produced by syncytiotrophoblast.

Aim of the work

The aim of this study was to determine the effectiveness of measuring maternal serum β-HCG, progesterone, CA125 in prediction of first trimester abortion.

Patients

The study included 90 pregnant women attending the ANC clinic in El-Shatby Maternity University Hospital. Patients were divided equally into two groups: Group I: 45 women with threatened abortion, subdivided into 2 subgroups: Subgroup A – Cases ended in abortion; Subgroup B – Cases continued as normal pregnancies. Group II: 45 pregnant women with normal pregnancy and were further subdivided into two subgroups: Subgroup C – Cases ended in abortion; Subgroup D – Cases continued as normal pregnancies.

Exclusion criteria

(1) Multiple pregnancies; (2) Anembryonic pregnancy; (3) Pregnant women with prior treatment with progesterone; (4) History of endometriosis; (5) Fibromyoma with pregnancy.

Methods

After clinical and sonographic examination, 3 mL venous blood have been taken once for estimation of serum level of β-hCG, progesterone and CA125 by quantitative ELISA.

Results

This is a case–control study. Out of the 90 pregnancies, 15 cases (16.6%) had aborted during follow-up, 9 cases (60%) of them had history of threatened abortion while 6 cases (40%) had no history of threatened abortion. Regarding Serum Progesterone level between studied groups, the calculated p value was <0.001. For Serum β HCG, the calculated p value was <0.001. In Serum CA125 the calculated p value was <0.001.