Predictive Value Of Free β-Hcg, Progesterone, And CA125 For First-Trimester Spontaneous Abortion In Asymptomatic Pregnant Women

Abstract

Introduction: Threatened miscarriage, characterized by vaginal bleeding with or without abdominal discomfort, is a common gynaecological condition affecting a significant portion of pregnancies. Progesterone and cancer antigen 125 (CA125) are implicated in miscarriage risk, while maternal serum human chorionic gonadotropin (hCG), particularly β-hCG, is a widely used biomarker for early pregnancy complications.

Material and Methods: A prospective longitudinal study was conducted for 2 years involving 100 pregnant women with threatened abortion. Biochemical parameters including free β-hCG, progesterone, and CA125 were assessed. Patients were monitored regularly, and blood samples were collected at specified intervals.

Results: Significant differences were observed in gravidity, number of previous miscarriages, progesterone levels, and CA125 among the study population. Sensitivity analysis revealed high sensitivity for β-hCG (93%), progesterone (86%), and CA125 (81%) in detecting abortion. Combining β-hCG, progesterone, and CA125 yielded 7% sensitivity, although with 100% specificity and predictive values.

Discussion: β-hCG, primarily of trophoblast origin, demonstrated strong diagnostic performance, consistent with previous research. Progesterone's role in pregnancy maintenance was evident, with low levels correlating with increased abortion risk. CA125's association with decidual damage suggests its potential as an early predictor of abortion, although further research is needed.

Conclusion: Single-parameter assessment of free β-hCG or progesterone levels can effectively predict first-trimester spontaneous abortions. Considering its availability and cost-effectiveness, progesterone may be preferred. The combination of β-hCG, progesterone, and CA125 did not significantly enhance predictive value. Future studies should focus on refining predictive models and elucidating the precise roles of biomarkers in abortion risk assessment.