Do levels of serum cancer antigen 125 and creatine kinase predict the outcome in pregnancies of unknown location?

Abstract

Absolute levels of serum CK and CA 125 at the defined times cannot be used to predict the outcome of PUL. Although the CA 125 ratio when incorporated into logistic regression model can distinguish failing PUL from IUP, its inability to detect the high risk PUL, i.e. the developing EP, renders it inappropriate for use in the clinical setting.

Prediction of Outcome in Women with Symptomatic First-Trimester Pregnancy: Focus on Intrauterine Rather Than Ectopic Gestation

“…It is also possible that not all EP have any well-known or identifiable risk factors. 12,13,18 Our model can help increase the accuracy of clinicians differentiating IUP vs. EP in patients seeking care with symptoms similar to those of both conditions. However, the use of this logistic regression model to predict IUP may not be practical in a clinical setting.…”

“…9,10 Studies of the use of different markers to differentiate between an intrauterine and extrauterine pregnancy have not been optimal. 8,[11][12][13][14][15][16] Follow-up care, treatment, and prognosis for a woman at risk for an EP depend on an accurate determination of both the location of a pregnancy (intrauterine or extrauterine) and the viability of a pregnancy. A fundamental issue in the diagnosis of symptomatic first-trimester pregnancies, not yet resolved, is whether efforts should be directed toward differentiating an EP from an IUP (either an IUP or an SAB) or instead toward differentiating a viable gestation (IUP) from a nonviable gestation (either an EP or an SAB).…”

Clinical information does not improve the performance of mathematical models in predicting the outcome of pregnancies of unknown location

“…These data were also used to develop logistic regression model M4 and to evaluate serum cancer antigen 125 and creatine kinase in the management of PULs, the results of which were previously published (6,12). A PUL was defined with TVS as there being no signs of either an intra-or an extrauterine pregnancy or retained products of conception in a woman with a positive pregnancy test.…”

Molecular diagnosis of ectopic pregnancy

“…Others have evaluated alternative marker combinations, including: inflammatory cytokines IL-6, IL-8 and TNF-a [17]; PAPP-A, inhibin A and activin A [18]; and cancer antigen-125 and CK [19] to identify women with EP, with varied success. Progesterone, inhibin and human chorionic gonadotrophin have also been combined to distinguish viable from nonviable IUP [20].…”