The Role of CA-125 Levels as a Prognostic Indicator for Response to Medical Treatment in Fallopian Ectopic Pregnancy
نویسندگان
1 Department of Obstetrics and Gynecology, Firoozabadi Clinical Research Development Unit (FACRDU), school of medicine, Iran University of Medical Sciences, Tehran,Iran
2 Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3 Firoozabadi Clinic Research Unit (FACRU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
4 Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran.
5 Department of gynecology, Faculty of Medicine, Tehran Medical sciences, Islamic Azad University, Tehran, Iran
6 Department of Gynecology and Obstetrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
7 Akbarabadi Clinical Research and Development Center Iran
8 Shiraz University of Medical Sciences, Shiraz, Iran
9 School of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
10 Shahid Akbarabadi clinical Research development unit (shACRDU), School of Medicine, Iran University of Medical Sciences, Tehran, Iran
doi
10.22037/aab.v15i1.46370چکیده
Introduction: Ectopic pregnancy (EP) involves implantation outside the uterus, posing risks of rupture and hemorrhagic shock. Biomarkers like CA-125 have shown potential in predicting EP progression. This study evaluates CA-125's diagnostic and therapeutic value, focusing on its association with complications in medically treated patients. Materials and Methods: This prospective cohort study included patients diagnosed with ectopic pregnancy (EP) who were deemed eligible for methotrexate treatment and provided informed consent. Serum β-hCG and CA-125 levels were measured on days 1, 4, and 7 of therapy. Participants were closely monitored for complications related to EP that might require surgical intervention, as well as their response to single-dose methotrexate and the progression of β-hCG levels throughout the treatment period. The study further investigated the patterns of CA-125 levels and their potential association with the development of complications and β-hCG trends. Results: The study included 100 patients with a mean age of 29.8 years. It was found that a portion of patients required a second dose of methotrexate or surgery. Single-dose methotrexate was effective in about half of the cases, while the other half required additional intervention. CA-125 levels were significantly elevated on days 4 and 7 in patients requiring a second dose of methotrexate and on day 1 in those requiring surgery (P < 0.001). Elevated CA-125 levels were also consistently observed across all days in patients with treatment failure (P < 0.001). Conclusion: In summary, monitoring serial CA-125 levels in cases of tubal pregnancy offers critical information regarding the risk of gestational sac rupture and assists in evaluating the need for surgical intervention or an additional dose of methotrexate (MTX).
