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Predictive power progesterone combined with beta human chorionic gonadotropin measurements in the outcome of threatened miscarriage

  • Materno-fetal Medicine
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the predictive power of progesterone combined with beta human chorionic gonadotropin (β-HCG) measurements in the outcome of threatened miscarriage.

Methods

This retrospective study was conducted on 245 intrauterine pregnant women from January 2006 to October 2008. 175 women with threatened miscarriages who consulted for vaginal bleeding received exogenous progesterone supplements. There were 108 patients with ongoing pregnancies until delivery and 67 patients with inevitable miscarriages. Control group included 70 pregnant women. Serum concentrations of progesterone and β-HCG were measured by Microparticle enzyme immunoassay between the fourth and fifth gestational weeks. The discrimination attained between the two study groups (ongoing pregnancies and inevitable miscarriages) was evaluated by logistic regression and receiver operating characteristic curve analysis.

Results

The mean serum levels of progesterone and β-HCG in patients with inevitable miscarriages (13.76 ± 5.52 ng/ml, 3,647.00 ± 2,123.00 mIU/ml, respectively) were significantly lower than these levels in normal intrauterine pregnancies (31.67 ± 5.86 ng/ml, 13,437.00 ± 6,256.00 mIU/ml, respectively) and ongoing pregnancies (25.47 ± 6.18 ng/ml, 8,492.00 ± 2,389.00 mIU/ml, respectively) (P < 0.001). Serum progesterone combined with β-HCG measurements, with a diagnostic accuracy of 85.7% (sensitivity 88.1%, specificity 84.3%), had the best prognostic reliability and significant differences were found when this parameter was compared with the predictive value of a single progesterone (diagnostic accuracy 72.5%, sensitivity 76.1%, specificity 70.4%) or β-HCG (diagnostic accuracy 74.8%, sensitivity 64.1%, specificity 81.4%) determinations. A combination of two biochemical parameters shows substantial improvement over a single-marker strategy.

Conclusions

Progesterone combined with β-HCG measurements may be useful for predicting the outcome of threatened miscarriage.

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References

  1. Griebel CP, Halvorsen J, Golemon TB, Day AA (2005) Management of spontaneous abortion. Am Fam Physician 72:1243–1250

    PubMed  Google Scholar 

  2. Wang X, Chen C, Wang L, Chen D, Guang W, French J (2003) Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril 79:577–584

    Article  PubMed  Google Scholar 

  3. Savitz DA, Hertz-Picciotto I, Poole C, Olshan AF (2002) Epidemiologic measures of the course and outcome of pregnancy. Epidemiol Rev 24:91–101

    Article  PubMed  Google Scholar 

  4. Barnhart KT, Sammel MD, Rinaudo PF, Zhou L, Hummel AC, Guo W (2004) Symptomatic patients with an early viable intrauterine pregnancy: HCG curves redefined. Obstet Gynecol 104:50–55

    Article  PubMed  Google Scholar 

  5. Al-Sebaim AH, Diver M, Hipkin LJ (1996) The role of a single free β-human chorionic gonadotrophin measurement in the diagnosis of early pregnancy failure and the prognosis of fetal viability. Hum Reprod 11:881–888

    Google Scholar 

  6. Condous G, Okaro E, Khalid A, Lu C, Huffe SV, Timmerman D, Bourne T (2005) A prospective evaluation of a single-visit strategy to manage pregnancies of unknown location. Hum Reprod 20:1398–1403

    Article  CAS  PubMed  Google Scholar 

  7. Letterie GS, Hibbert M (2000) Serial serum human chorionic gonadotropin (hCG) levels in ectopic pregnancy and first trimester miscarriage. Arch Gynecol Obstet 263:168–169

    Article  CAS  PubMed  Google Scholar 

  8. Chung K, Allen R (2008) The use of serial human chorionic gonadotropin levels to establish a viable or a nonviable pregnancy. Semin Reprod Med 26:383–390

    Article  PubMed  Google Scholar 

  9. Dumpsa P, Meisser A, Pons D, Morales MA, Anguenot JL, Campana A, Bischof P (2002) Accuracy of single measurements of pregnancy-associated plasma protein-A, human chorionic gonadotropin and progesterone in the diagnosis of early pregnancy failure. Eur J Obstet Gynecol Reprod Biol 100:174–180

    Article  Google Scholar 

  10. Day A, Sawyer E, Mavrelos D, Tailor A, Helmy S, Jurkovic D (2009) Use of serum progesterone measurements to reduce need for follow-up in women with pregnancies of unknown location. Ultrasound Obstet Gynecol 33:704–710

    Article  CAS  PubMed  Google Scholar 

  11. Al-Sebai MAH, Kingsland CR, Diver M, Hipkin L, McFadyen IR (2005) The role of a single progesterone measurement in the diagnosis of early pregnancy failure and the prognosis of fetal viability. Int J Gynecol Obstet 122:364–369

    Google Scholar 

  12. Cowan BD, Vandermolen DT, Long CA, Whitworth NS (1992) Receiver–operator characteristic, efficiency analysis and predictive value of serum progesterone as a test for abnormal gestations. Am J Obstet Gynecol 166:1729–1737

    CAS  PubMed  Google Scholar 

  13. Katsikis I, Rousso D, Farmakiotis D, Kourtis A, Diamanti Kandarakis E, Panidis D (2006) Receiver operator characteristics and diagnostic value of progesterone and CA-125 in the prediction of ectopic and abortive intrauterine gestations. Eur J Obstet Gynecol Reprod Biol 125:226–233

    Article  CAS  PubMed  Google Scholar 

  14. Al-Sebai MA, Kingsland CR, Diver M, Hipkin L, Mc Fadyen IR (1995) The role of a single progesterone measurement in the diagnosis of early pregnancy failure and the prognosis of fetal viability. J Obstet Gynaecol 102:364–369

    CAS  Google Scholar 

  15. Gharabaghi P, Abdollahifard S, Gharabaghi M, Nouri M (2007) Comparing the levels of ssHCG, progesterone and estradiol between ectopic pregnancy and normal intrauterine pregnancy. Iran J Reprod Med 5:187–190

    CAS  Google Scholar 

  16. El Bishry G, Ganta S (2008) The role of single serum progesterone measurement in conjunction with hCG in the management of suspected ectopic pregnancy. J Obstet Gynaecol 28:413–417

    Article  CAS  PubMed  Google Scholar 

  17. Phipps MG, Hogan JW, Peipert JF, Lambert-Messerlian GM, Canick JA, Seifer DB (2000) Progesterone, inhibin, and hCG multiple marker strategy to differentiate viable from nonviable pregnancies. Obstet Gynecol 95:227–231

    Article  CAS  PubMed  Google Scholar 

  18. Hanley JA, McNeil BJ (1982) The meaning and use of the area under receiving operating characteristic (ROC) curve. Radiol 143:29–36

    CAS  Google Scholar 

  19. Banerjee S, Aslam N, Woelfer B, Lawrence A, Elson J, Jurkovic D (2001) Expectant management of early pregnancies of unknown location: a prospective evaluation of methods to predict spontaneous resolution of pregnancy. Br J Obstet Gynaecol 108:158–163

    Article  CAS  Google Scholar 

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Correspondence to Weiyue Zeng.

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Duan, L., Yan, D., Zeng, W. et al. Predictive power progesterone combined with beta human chorionic gonadotropin measurements in the outcome of threatened miscarriage. Arch Gynecol Obstet 283, 431–435 (2011). https://doi.org/10.1007/s00404-010-1367-7

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  • DOI: https://doi.org/10.1007/s00404-010-1367-7

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