abstract
OBJECTIVE:
To establish reference intervals for
cancer antigen 125 (CA-125) in women with expected normal pregnancy, delivery, and early postpartum period.
DESIGN:
Prospective observational study.
POPULATION:
Eight
hundred and one women with expected normal pregnancies were
investigated. Of these, 640 delivered vaginally, 82 by emergency
cesarean section, and 79 by elective cesarean section; 720 women had
uncomplicated pregnancies.
METHODS:
Samples
were collected at gestational weeks 13-20, 21-28, 29-34, 35-42, during
labor, and on first and second day postpartum. Reference intervals were
calculated for each gestational period as recommended by the
International Federation of Clinical Chemistry and Laboratory Medicine.
MAIN OUTCOME MEASURES:
Concentration of serum CA-125 during the gestational period and around delivery.
RESULTS:
CA-125
was fairly stable below 35 U/mL during pregnancy but increased markedly
during vaginal delivery, to a minor degree during emergency cesarean
section, and only slightly during elective cesarean section. In the
early postpartum period, CA-125 decreased with an apparent half-life of
24 h.
CONCLUSIONS:
The
CA-125 cut-off value (<35 U/mL) used for non-pregnant women can be
used for women during pregnancy after gestational week 13
as a
supplement to ultrasound evaluation of ovarian
cysts. The wide range of CA-125 concentration during normal pregnancies
makes it unlikely that small fluctuations in CA-125 can be clinically
useful for identifying other conditions. Measuring CA-125 around the
time of delivery is not recommended. Gestational age-specific reference
intervals during normal pregnancy are not needed.
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