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Predictive power of serum CA-125 and LDH in the outcome of first trimester pregnancies with human chorionic gonadotropin levels below discriminatory zone

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Abstract

Background

The present study aims to investigate the predictive power of serum CA-125 and lactate dehydrogenase (LDH) for evaluating the outcome of first trimester pregnancies with beta human chorionic gonadotropin levels below discriminatory zone (≤1,000 mIU/mL).

Methods

A total of 107 women with tubal ectopic pregnancies (30 ruptured and 77 unruptured), 105 women with normal intrauterine pregnancies and 100 women with intrauterine abortions were eligible for the study.

Results

Women with intrauterine abortion were found to have significantly higher CA-125 and LDH levels compared to women with ectopic and normal intrauterine pregnancies. Ruptured tubal pregnancies resulted in significantly higher CA-125 and statistically similar LDH levels compared with unruptured tubal pregnancies. Although CA-125 levels were found to be unrelated to gestational age in normal intrauterine normal and abortive as well as ruptured and unruptured ectopic pregnancies; LDH levels were directly correlated with gestational age in ruptured tubal ectopic pregnancies.

Discussıon

Consequently, the ability to determine the disintegration of ectopic trophoblastic or fetal tissues would be of great value in the management of hemodynamically stable patients with beta hCG levels below discriminatory zone. Intrauterine abortive pregnancies seem to yield high serum CA-125 concentrations combined with high LDH levels which indicate more extensive trophoblastic tissue damage than caused by intrauterine and ectopic pregnancies.

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References

  1. Pisarska MD, Carson SA, Buster JE (1998) Ectopic pregnancy. Lancet 351:1115. doi:10.1016/S0140-6736(97)11476-3

    Article  PubMed  CAS  Google Scholar 

  2. Koonin LM, Mackay AP, Berg CJ (1997) Pregnancy-related mortality surveillance-United States, 1987–1990. MMWR CDC Surveill Summ 46:17

    PubMed  CAS  Google Scholar 

  3. Della-Giustina D, Denny M (2003) Ectopic pregnancy. Emerg Med Clin North Am 21:565–584. doi:10.1016/S0733-8627(03)00036-1

    Article  PubMed  Google Scholar 

  4. Lemus JF (2000) Ectopic pregnancy: an update. Curr Opin Obstet Gynecol 12(5):369–375. doi:10.1097/00001703-200010000-00005

    Article  PubMed  CAS  Google Scholar 

  5. Check JH, Nowroozi K, Winekl CA, Johnson T, Seefried L (1990) Serum CA-125 levels in early pregnancy and subsequent spontaneous abortion. Obstet Gynecol 75:742–744

    PubMed  CAS  Google Scholar 

  6. Jacobs IJ, Fay TN, Stabile I, Bridges JE, Oram DH, Grudzinskas JG (1988) The distribution of CA-125 in the reproductive tract of pregnant and non-pregnant women. Br J Obstet Gynaecol 95:1190–1194

    PubMed  CAS  Google Scholar 

  7. Spitzer M, Kaushal N, Benjamin F (1998) Maternal CA-125 levels in pregnancy and puerperium. J Reprod Med 43:387–392

    PubMed  CAS  Google Scholar 

  8. Noci I, Biagiotti R, Periti E, Baronci D, Torricelli F, Cefala L (1995) Maternal serum CA-125 levels in first trimester abortion. Eur J Obstet Gynecol Reprod Biol 60:35–36. doi:10.1016/0028-2243(95)02073-X

    Article  PubMed  CAS  Google Scholar 

  9. Azogui G, Yaronovski A, Zohar S (1996) CA-125 is elevated in viable pregnancies destined to be miscarried: a prospective longitudinal study. Fertil Steril 65:1059–1061

    PubMed  CAS  Google Scholar 

  10. Sauer VM, Vasilev AS, Campeau J, Vermesh M (1989) Serum cancer antigen 125 in ectopic pregnancy. Gynecol Obstet Invest 27:164–165

    Article  PubMed  CAS  Google Scholar 

  11. Brumsted JR, Nakajima ST, Badger G, Riddick DH (1990) Serum concentration of CA-125 during the first trimester of normal and abnormal pregnancies. J Reprod Med 35:499–502

    PubMed  CAS  Google Scholar 

  12. Sadovsky Y, Pineda J, Collins JL (1991) Serum CA-125 levels in women with ectopic and intrauterine pregnancies. J Reprod Med 36:875–878

    PubMed  CAS  Google Scholar 

  13. Kobayashi F, Takashima E, Sagawa N, Mori T, Fujii S (1993) Maternal serum CA-125 levels in early intrauterine and tubal pregnancies. Arch Gynecol Obstet 252:1865–1869. doi:10.1007/BF02426356

    Article  Google Scholar 

  14. Kuscu E, Vicdan K, Turhan NO, Oguz S, Zorlu G, Gokmen O (1993) The hormonal profile in ectopic pregnancies. Mater Med Pol 25:149–152

    PubMed  CAS  Google Scholar 

  15. Predanic M (2000) Differentiating tubal abortion from viable ectopic pregnancy with serum CA-125 and beta-human chorionic gonadotropin determinations. Fertil Steril 73:522–525. doi:10.1016/S0015-0282(99)00554-3

    Article  PubMed  CAS  Google Scholar 

  16. Schmidt T, Rein DT, Foth D (2001) Prognostic value of repeated serum CA 125 measurements in first trimester pregnancy. Eur J Obstet Gynecol Reprod Biol 97:168–173. doi:10.1016/S0301-2115(00)00533-9

    Article  PubMed  CAS  Google Scholar 

  17. Malatyalioglu E, Ozer S, Kokcu A, Cetinkaya MB, Alper T, Tosun M (2006) CA-125 levels in ruptured and unruptured tubal ectopic pregnancies. J Obstet Gynaecol Res 32(4):422–427. doi:10.1111/j.1447-0756.2006.00424.x

    Article  PubMed  Google Scholar 

  18. Katsikis I, Rousso D, Farmakiotis D, Kourtis A, Diamanti-Kandarakis E (2006) Receiver operator characteristics and diagnostic value of progesterone and CA-125 in the prediction of ectopic and abortive intrauterine gestations. Eur J Obstet Gynecol Reprod Biol 125(2):226–232. doi:10.1016/j.ejogrb.2005.10.014

    Article  PubMed  CAS  Google Scholar 

  19. Stark G, Knüppel U (1966) The content of enzyme activity of GOT, GPT, LDH and MDH in the serum in various obstetric and gynecologic situations. Arch Gynakol 203(4):354–365. doi:10.1007/BF00673135

    Article  PubMed  CAS  Google Scholar 

  20. Grünberger W (1987) Tubal pregnancy: lactate dehydrogenase as a differential diagnostic parameter. Zentralbl Gynakol 109(6):358–363

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Perinatology, Dr Zekai Tahir Burak Women Health Research and Education Hospital, Ankara, Turkey

    Yusuf Madendag, Ilknur Col-Madendag, Mine Kanat-Pektas & Nuri Danisman

  2. Ertugrul Gazi Mah., Kutlugun Sok. No: 37/14, Iccebeci, 06590, Ankara, Turkey

    Mine Kanat-Pektas

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  1. Yusuf Madendag
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  2. Ilknur Col-Madendag
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Correspondence to Mine Kanat-Pektas.

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Madendag, Y., Col-Madendag, I., Kanat-Pektas, M. et al. Predictive power of serum CA-125 and LDH in the outcome of first trimester pregnancies with human chorionic gonadotropin levels below discriminatory zone. Arch Gynecol Obstet 279, 661–666 (2009). https://doi.org/10.1007/s00404-008-0798-x

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  • DOI: https://doi.org/10.1007/s00404-008-0798-x

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