Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND :
Prompt diagnosis of ectopic pregnancy is a difficult dilemma, and reliable predictors for diagnosis and differentiation of ectopic pregnancy from early pregnancy miscarriage are needed.
OBJECTIVE:
To evaluate the diagnostic value of serum progesterone and CA-125 levels in ectopic pregnancy and early intra uterine miscarriage.
Study design: A prospective case control study
Setting: The study was carried out in the department of obstetrics and gynecology of AL-Yarmouk teaching hospital (Baghdad – Iraq) from February 2011 to February 2012
PATIENTS AND METHODS:
This study was carried out on sixty pregnant women in their first trimester. Twenty women diagnosed as unruptured ectopic pregnancy; treated by laparotomy ,twenty women diagnosed as inevitable miscarriage; treated by curettage and twenty women with healthy pregnancy of a comparable gestational age as control group; follow up of this group was done to ascertain uneventful pregnancy with no complications.
We compared the serum levels of progesterone and CA-125 in all groups at the time of presentation and 24h after surgical intervention in first and second groups.
RESULTS :
There was a significant decrease in mean post operative progesterone level in women with ectopic pregnancy and miscarriage groups with significant difference (P<0.0001). The study observed that the mean level of progesterone in women with ectopic group (6.76±3.63 ng/ml) was lower than that in miscarriage group (15.17±6.01 ng/ml) and control group (17.58±4.57 ng/ml) with significant difference (P<0.0001). This study also observed that the mean level of CA-125 in women with miscarriage group (117.07±94.30 U/ml) was higher than that in ectopic group (38.11±28.79 U/ml) and control group (30.51±16.10 U/ml) with statistically significant difference (P<0.0001).
There was a significant decrease in mean level of post operative CA-125 in women with ectopic pregnancy and miscarriage groups with significant difference (P<0.0003).
CONCLUSION:
Combined measurement of both serum progesterone and CA-125 can be sensitive predictors in diagnosis and differentiation of ectopic pregnancy from inevitable miscarriage and normal pregnancy.