title: Amniotic fluid CA-125 as a marker of intra-amniotic inflammation associated with preterm delivery: a preliminary single center study.
abstract: OBJECTIVE
  The purpose of this study was to investigate whether amniotic fluid (AF) CA-125 in patients with preterm labor or preterm premature rupture of membranes can help predict intra-amniotic inflammation (IAI), microbial invasion of the amniotic cavity (MIAC) and imminent delivery.
  
  
  METHODS
  We recruited 36 women who admitted with impending preterm delivery and suspicious AF infection. AF matrix metalloproteinase-8 (MMP-8), white blood cell (WBC) count, glucose levels, and CA-125 levels were measured, and the MMP-8 bedside rapid test was also performed. AF culture and PCR were subsequently performed to confirm MIAC. We compared AF CA-125 levels according to the presence of IAI or MIAC and assessed its predictive value for delivery within 7 days of admission.
  
  
  RESULTS
  AF CA-125 levels were significantly higher in the IAI group than in the non-IAI group (mean ± standard deviation: 5608 ± 864 vs 904 ± 84 IU/ml; p = 0.001). AF CA-125 levels showed a negative correlation with gestational age and a positive correlation with AF WBC counts and MMP-8 levels. AF CA-125 levels were higher in the MIAC group, though this difference was not statistically significant (p = 0.064). Delivery within 7 days of admission was significantly more common in patients with higher AF CA-125 levels (cut-off: 1650 IU/ml, sensitivity: 71.4 %, specificity: 86.4 %, p = 0.005).
  
  
  CONCLUSIONS
  AF CA-125 levels are increased in patients with AF inflammation and can be a predictor of imminent preterm delivery.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Kyungpook National University, Samduk 2 Ga, JungGu, Daegu, South Korea. wjseong@knu.ac.kr.
authors.forename: Won Joon
authors.initials: WJ
authors.lastname: Seong
mesh_terms: D000328:Adult; D000650:Amnion / Q000276:immunology / Q000382:microbiology*; D000653:Amniotic Fluid / Q000276:immunology* / Q000382:microbiology; D001419:Bacteria / Q000254:growth & development; D018394:CA-125 Antigen / Q000276:immunology*; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000378:metabolism / Q000382:microbiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000276:immunology / Q000378:metabolism / Q000382:microbiology; D020784:Matrix Metalloproteinase 8 / Q000032:analysis / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000175:diagnosis / Q000276:immunology* / Q000378:metabolism; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011247:Pregnancy; D047928:Premature Birth / Q000209:etiology* / Q000276:immunology; D012680:Sensitivity and Specificity
chemical_list: D018394:CA-125 Antigen; D020784:Matrix Metalloproteinase 8
keywords: CA-125; Intra-amniotic inflammation; Preterm labor; Preterm premature rupture of membrane