Differentiating tubal abortion from viable ectopic pregnancy with serum CA-125 and beta-human chorionic gonadotropin determinations.
OBJECTIVE
To determine whether serum CA-125 and serial beta-hCG levels can be used to distinguish between tubal abortion and viable ectopic pregnancy (EP).


METHODS
Retrospective cohort study.


METHODS
A tertiary care institution.


METHODS
Twenty-six women with EPs of 7-12 weeks' duration were studied retrospectively. Five had laparoscopically proved tubal abortions and 21 had active, viable EPs at the time of entry into the study. All but 3 of the latter group were managed surgically; the others were given a single dose of methotrexate.


METHODS
Surgical removal of EPs by means of laparoscopy or laparotomy, or medical treatment of the disease.


METHODS
Serum CA-125 and beta-hCG determinations were used to differentiate tubal abortion and viable EP. The results were compared with the findings at surgery.


RESULTS
The mean (+/-SD) CA-125 level was 112.2 +/- 11.9 IU/mL for the patients with tubal abortion and 30.1 +/- 15.3 IU/mL for the patients with viable EP. The mean (+/-SD) beta-hCG level was 3,643 +/- 3,718 IU/L for the patients with tubal abortion and 10,755 +/- 11,465 IU/L for the patients with viable EP. Linear regression analysis showed a statistically insignificant inverse relation between serum CA-125 and beta-hCG levels.


CONCLUSIONS
The use of CA-125 levels as an adjunct to serial beta-hCG levels shows promise as a means for differentiating tubal abortion from viable EP.
Predanic
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Department of Obstetrics and Gynecology, Flushing Hospital Medical Center, Flushing, New York 11355, USA.
D000022:Abortion, Spontaneous / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D015331:Cohort Studies; D003937:Diagnosis, Differential; D005187:Fallopian Tubes; D005260:Female; D005313:Fetal Death; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D012044:Regression Analysis; D012189:Retrospective Studies
D015415:Biomarkers; D018394:CA-125 Antigen; D018997:Chorionic Gonadotropin, beta Subunit, Human