Study of the predictive accuracy of maternal serum CA- 125 levels combined with yolk sac sonographic parameters as a tool for detecting pregnancy outcome in first trimesteric threatened abortion

Abstract

Aim : To assess the accuracy of a combination of ultrasound parameters of yolk sac and maternal serum CA125 levels for prediction of pregnancy outcomes in 1st trimesteric threatened abortion. Methods : A total 90 preganant women from 5 to 12 wks with singleton preganacy . There were assigned into group 1 (n=30) normal pregnancy and group 2(n=43) with threatened abortion who continued their pregnancy and group 3(n=17) with threatened abortion who aborted. The yolk sacs were examined and maternal serum CA125 levels were measured. Results : The mean level of CA-125 in G 1 was 28.1±7.1 IU/ml and in G 2 was 34.1±4.7 IU/ml while in G 3 was 58.5±12.9 IU/ml. There was statistically significant difference between the three groups regarding CA125. Regarding the G 3 7 patients out of 17 showed absent YS (41.17%). There was a statistically significant difference between G 1 and G 3 and between G 2 and G 3 regarding absent yolk sac (p <0.05), but no statistically significant differences were observed between G 1 and G 2 who (p > 0.05). For the mean yolk sac diameter, there was a statistically significant difference between the three groups. The sensitivity, specificity for predicting adverse outcomes using CA 125 and abnormal YSD, were 76.5%and 100% respectively with accuracy 95.6% in detecting abortion. Conclusion : The combination of ultrasound scanning of yolk sacs and measurement of maternal serum CA125 levels is of great value for predicting pregnancy outcomes.

Keywords .. Miscarriage , Cancer antigen 125 (CA-125) , Yolk sac .