Reproductive Endocrinology
Differentiating tubal abortion from viable ectopic pregnancy with serum CA-125 and β-human chorionic gonadotropin determinations

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Abstract

Objective: To determine whether serum CA-125 and serial β-hCG levels can be used to distinguish between tubal abortion and viable ectopic pregnancy (EP).

Design: Retrospective cohort study.

Setting: A tertiary care institution.

Patient(s): 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.

Intervention(s): Surgical removal of EPs by means of laparoscopy or laparotomy, or medical treatment of the disease.

Main Outcome Measure(s): Serum CA-125 and β-hCG determinations were used to differentiate tubal abortion and viable EP. The results were compared with the findings at surgery.

Result(s): 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) β-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 β-hCG levels.

Conclusion(s): The use of CA-125 levels as an adjunct to serial β-hCG levels shows promise as a means for differentiating tubal abortion from viable EP.

Keywords

Ectopic pregnancy
tubal abortion
CA-125
β-hCG

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