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

Fertil Steril. 2000 Mar;73(3):522-5. doi: 10.1016/s0015-0282(99)00554-3.


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.

MeSH terms

  • Abortion, Spontaneous / blood
  • Abortion, Spontaneous / diagnosis*
  • Biomarkers / blood
  • CA-125 Antigen / blood*
  • Chorionic Gonadotropin, beta Subunit, Human / blood*
  • Cohort Studies
  • Diagnosis, Differential
  • Fallopian Tubes
  • Female
  • Fetal Death
  • Humans
  • Predictive Value of Tests
  • Pregnancy
  • Pregnancy, Ectopic / blood
  • Pregnancy, Ectopic / diagnosis*
  • Pregnancy, Ectopic / surgery
  • Regression Analysis
  • Retrospective Studies


  • Biomarkers
  • CA-125 Antigen
  • Chorionic Gonadotropin, beta Subunit, Human