Witt B R, Miles R, Wolf G C, Koulianos G T, Thorneycroft I H
Department of Obstetrics and Gynecology, Tulane University School of Medicine, New Orleans, Louisiana.
Am J Obstet Gynecol. 1991 May;164(5 Pt 1):1225-8. doi: 10.1016/0002-9378(91)90687-m.
The diagnosis of abruptio placentae is frequently difficult despite ultrasonography; additional diagnostic parameters would be useful. Maternal serum CA 125, which is believed to derive from the decidua, is elevated in the first trimester and immediately after delivery when placental separation occurs, possibly because of decidual disruption. Serum CA 125 was measured in 27 patients beyond 20 weeks' gestation who were first seen with vaginal bleeding and in 17 control patients of similar gestational age and labor status. Mean (+/- SD) CA 125 levels were higher (p less than 0.01) among patients with abruptio placentae (105.9 +/- 115 U/ml) than among those with alternate sources of bleeding (13.7 +/- 10 U/ml) or control patients (18.2 +/- 11.7 U/ml). Mean (+/- SD) serum CA 125 levels in seven control patients within 6 hours post partum (194 +/- 80.5 U/ml) were higher than those among patients first seen with abruptio placentae (p less than 0.01). Sensitivity and specificity of CA 125 for abruptio placentae were 70% and 94%, respectively. Our data support a decidual source for CA 125 and may indicate utility of CA 125 as a marker for abruptio placentae.
尽管有超声检查，但胎盘早剥的诊断常常很困难；额外的诊断参数会很有用。母体血清CA 125被认为来源于蜕膜，在孕早期以及胎盘分离发生后的分娩即刻会升高，可能是由于蜕膜破裂。对27例妊娠20周以上首次因阴道出血就诊的患者以及17例孕周和分娩状态相似的对照患者测定了血清CA 125。胎盘早剥患者的平均（±标准差）CA 125水平（105.9±115 U/ml）高于其他出血原因患者（13.7±10 U/ml）或对照患者（18.2±11.7 U/ml）（p<0.01）。7例产后6小时内的对照患者的平均（±标准差）血清CA 125水平（194±80.5 U/ml）高于首次诊断为胎盘早剥的患者（p<0.01）。CA 125对胎盘早剥的敏感性和特异性分别为70%和94%。我们的数据支持CA 125来源于蜕膜，并可能表明CA 125作为胎盘早剥标志物具有实用性。
