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

Objective: To determine whether serum CA-125 and serial beta-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 beta-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) beta-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 beta-hCG levels, Conclusion(s): The use of CA-125 levels as an adjunct to serial beta-hCG levels shows promise as a means for differentiating tubal abortion from viable EP. (C) 2000 by American Society for Reproductive Medicine.