Objective: To assess the predictive value of E2, hCG, CA-125, and morphometric parameters in early pregnancies with demonstrable fetal heartbeat, complicated by bleeding.
Design: Prospective longitudinal follow-up.
Setting: The emergency service of the Department of Obstetrics and Gynecology, "Rebecca Sieff" Hospital, Safed, Israel.
Patients: Twenty-five consecutive patients with vaginal bleeding during weeks 7 to 12 of pregnancy who had demonstrable fetal heartbeat. Ten women with normal pregnancies, serving as controls.
Main Outcome Measure: The serum levels and the morphometric parameters were related to the outcome of pregnancy as revealed by future hospitalization, delivery, or telephone questioning.
Results: In the five patients who eventually aborted, the values of CA-125 were > 125 U/mL, whereas none of the successful pregnancies had a value > 93 U/mL. The mean values were 133 +/- 4.85 versus 36.95 +/- 23.1 U/mL for miscarriages and successful pregnancies, respectively. In normal pregnancies the respective value was 32.3 +/- 4.3 U/mL. Although mean E2 levels were lower in the serum of women who eventually aborted, there was a significant overlap of values with the successful pregnancies. All the other parameters measured had no correlation to the outcome of these pregnancies.
Conclusion: CA-125 may serve as an accurate predictor of the outcome in early pregnancies with demonstrable fetal heartbeat, which are complicated by bleeding.
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