DIAGNOSTIC AND PROGNOSTIC ROLE OF SERUM CA-125 IN THREATENED ABORTION : A HOSPITAL BASED COHORT STUDY

Abstract

Introduction: A signicant proportion of pregnancies presenting with early bleeding end up in poor outcome (abortion). Present study aim to evaluate CA-125 level as diagnostic and prognostic indicator in threatened abortion. Material and Methods: This Hospital based prospective cohort study was conducted included 75 cases of threatened abortion and 75 controls. “Threatened abortion” group included females presenting with 6 to 12 weeks gestation, with a demonstrable fetal heartbeat on ultrasonography, with complain of vaginal bleeding with or without abdominal cramps. 'Threatened abortion' group females were followed and divided into two groups based on their outcome- Threatened abortion ended with Abortion (TAEA) or Threatened abortion with ongoing pregnancy (TAOP). Results: Out of the 75 patients with threatened abortion, 27 (36%) ended with abortion. The mean CA-125 levels were found to be signicantly higher (p<0.001) in TAEAgroup (89.44 U/ml) as compared to TAOP group (44.69 U/ml) and Control group (24.73 U/ml). Ahigh Area under the ROC curve of 0.916 (95% CI- 0.828 – 1.00) indicated that CA-125 is a good predictor of abortion among females presenting with threatened abortion (p<0.001). At the critical cutoff of 58.5 U/ml, CA-125 had sensitivity and specicity of 88.9% and 93.7% respectively for predicting abortion. Conclusion: Evaluation of maternal serum CA-125 levels in females with early pregnancy bleeding would allow closer and individualized antenatal monitoring, earlier diagnosis, and timely interventions, which could potentially improve pregnancy outcomes.