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| Tumor markers | Associated histological types of ovarian and other tumors | Changes in pregnancy | Observations |
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| CA 125 | Ovarian epithelial tumors | Increased in 1st trimester:
(i) Starts at 30–40 d after LMP, peaks at 35–60 d
(ii) May reach 1250 U/mL
(iii) Decrease at the end of 1st T | Useful as tumor marker for ovarian epithelial tumors between 15 weeks of gestation and delivery |
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| CEA | Epithelial tumors (particularly, colorectal carcinoma) | Serum levels not influenced by pregnancy | Can be used as tumor marker in pregnancy |
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| CA 19.9 | Gastrointestinal, pancreatic, and other adenocarcinomas
Ovarian mucinous tumors | Mildly increased levels with increased gestational age, but never exceeding the normal range | Can be used as tumor marker in pregnancy |
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| b-HCG | Germ cell tumors (particularly, choriocarcinoma) | Physiologically increased during pregnancy | Not possible to use as tumor marker during pregnancy |
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| AFP | Germ cell tumors (endodermal sinus tumor, embryonal carcinoma, and mixed tumors) | Physiologically increased during pregnancy
Abnormally increased in NTD and decreased in Down syndrome | Serum levels usually <500 ng/mL in pregnancy complicated by NTD and >1000 ng/mL in germ cell tumors |
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| LDH | Dysgerminomas | Increased in pregnancy diseases (severe preeclampsia, HELLP syndrome) | |
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| Inhibin A | Granulosa cell tumors; mucinous carcinoma | Increased in 1st trimester (produced by developing placenta)
Abnormally increased in Down syndrome | (i) Used in 2nd trimester for Down syndrome screening
(ii) Increased levels require fetal and ovarian evaluation |
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| He4 | Serous, endometrioid, and clear cell epithelial tumors | Lower levels in pregnant women
Mildly increased in 3rd T compared to 2nd T
Elevated levels can also be found in PTD | Promising tumor marker, but its value in pregnancy is not established |
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