International Journal of Clinical Obstetrics and Gynaecology

Background: Threatened abortion is a common complication of early pregnancy and is associated with significant maternal anxiety and adverse outcomes. Identifying reliable biochemical markers to predict pregnancy outcome is clinically valuable. Serum cancer antigen?125 (CA?125), a glycoprotein released from decidual and trophoblastic tissue, has been proposed as a prognostic marker in early pregnancy bleeding.

Objectives: To evaluate the role of maternal serum CA?125 as a prognostic marker in threatened abortion and to assess its association with adverse pregnancy and fetal outcomes.

Methods: This prospective hospital?based observational study was conducted in the Department of Obstetrics and Gynecology, SMGS Hospital, GMC Jammu, from May 2024 to April 2025. A total of 225 pregnant women aged 20-40 years with singleton pregnancies of 7-14 weeks’ gestation presenting with vaginal bleeding were enrolled. Serum CA?125 levels were measured at presentation using chemiluminescent immunoassay. Participants were followed until pregnancy outcome. Statistical analysis included chi?square test and ROC curve analysis.

Results: Of 225 women, 75 (33.3%) experienced abortion while 150 (66.7%) continued pregnancy beyond the period of viability. Mean serum CA?125 levels were significantly higher in the abortion group (112.4?±?48.76 U/mL) compared to the non?abortion group (45.1?±?18.24 U/mL; p<0.001). A cutoff value of >65?U/mL predicted abortion with sensitivity 86.7%, specificity 92.6%, and AUC 0.968. Elevated CA?125 levels were also significantly associated with adverse fetal outcomes.