The Role of Homocysteine and CA125 in the Differentiation between Ectopic Pregnancy and Spontaneous Abortion in First Trimester
Iraqi Postgraduate Medical Journal,
2020, Volume 19, Issue 2, Pages 156-164
Ectopic pregnancy and spontaneous abortion are the two common complications seen in early
pregnancy. While spontaneous abortion is the most common complication of pregnancy, ectopic
pregnancy is the most life threatening emergency in early pregnancy.
To investigate the diagnostic value of serum homocysteine and CA-125 levels for early diagnosis
and differentiation for early pregnancy complications.
PATIENTS AND METHODS:
The study included 90 pregnant women, aged from 21 to 40 years old presented with a gestational
age ranging between 5-13 weeks. The patients were divided into three groups, group A included 30
cases of ectopic pregnancies, group B Included 30 cases who presented with spontaneous abortions
and group C included 30 cases who presented as normal uncomplicated pregnancies and were
followed up till their normal term deliveries and was considered as the control group. All women in
the studied groups underwent CA125 and serum homocysteine measurements by radioimmune assay
and Enzyme-linked immunosorbent assay (ELISA) respectively.
Regarding group A, the majority of cases had low levels of serum homocysteine on admission (60%)
and only one case changed from low to high level after one week from surgical termination of
pregnancy. The CA125 readings were subdivided into two subdivisions: the first subdivision was the
ruptured ectopic pregnancy cases on admission and diagnosis and they were 20 out of the 30 cases
of ectopic pregnancy, half of these cases (50%) had high CA125 levels on admission and 3 patients
had returned to normal after one week from surgical termination of pregnancy, in the second
subdivision (unruptured ectopic pregnancies which were10 cases), the vast majority of patients
(90%) had normal CA125 levels on admission and all of them had returned to normal after one week
from the surgical termination of pregnancy. Regarding group B, (56.7%) of patients had high levels
of serum homocysteine on admission and none of them had returned to normal value after one week
from spontaneous or interventional completeness of the abortion, while the results of CA125 showed
that (63.3%) of patients had high levels of this tumor marker on admission and 6 cases had returned
to normal levels after one week from spontaneous or interventional completeness of the abortion.
In group C, the majority of the cases were within normal ranges of both CA125 and serum
homocysteine both at admission and one week follow up. (90% and 93.3% regarding CA125) and
(76.6% and 70% regarding serum homocysteine).
The measurement of serum homocysteine and CA125 was found to be an effective method for early
diagnosis and differentiation between spontaneous abortion and ectopic pregnancy.
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