CA-125 is elevated in viable pregnancies destined to be miscarried: A prospective longitudinal study

Objective: To assess the predictive value of E₂, hCG, CA-125, and morphometric parameters in early pregnancies with demonstrable fetal heartbeat, complicated by bleeding. Design: Prospective longitudinal follow- up. Setting: The emergency service of the Department of Obstetrics and Gynecology, 'Rebecca Sieff' Hospital, Safed, Israel. Patients: Twenty-five consecutive patients with vaginal bleeding during weeks 7 to 12 of pregnancy who had demonstrable fetal heartbeat. Ten women with normal pregnancies, serving as controls. Main Outcome Measure: The serum levels and the morphometric parameters were related to the outcome of pregnancy as revealed by future hospitalization, delivery, or telephone questioning. Results: In the five patients who eventually aborted, the values of CA-125 were >125 U/mL, whereas none of the successful pregnancies had a value >93 U/mL. The mean values were 133 ± 4.85 versus 36.95 ± 23.1 U/mL for miscarriages and successful pregnancies, respectively. In normal pregnancies the respective value was 32.3 ± 4.3 U/mL. Although mean E₂ levels were lower in the serum of women who eventually aborted, there was a significant overlap of values with the successful pregnancies. All the other parameters measured had no correlation to the outcome of these pregnancies. Conclusion: CA-125 may serve as an accurate predictor of the outcome in early pregnancies with demonstrable fetal heartbeat, which are complicated by bleeding.