Some endocrinological events associated with early pregnancy failure

Whittaker, Paul; Stewart, Marguerite; Taylor, Amy; Lind, T.

doi:10.1111/j.1471-0528.1989.tb03198.x

Cited by 29 publications

(12 citation statements)

References 26 publications

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“…These findings are in agreement with Yovich et al [22], but contrary to other investigators who have found a decrease in E2 and P4 secretion to be associated with an increased risk of miscarriage [2,6,11,12,18].…”

Section: Discussionsupporting

confidence: 63%

Comparison of maternal serum estradiol and progesterone levels in pregnancies after induced and spontaneous ovulation

Hassiakos

Mantzavinos

Kalomiris

et al. 1991

Arch Gynecol Obstet

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Maternal serum estradiol and progesterone levels during the early 6th to 15th weeks of gestation, were measured by radioimmunoassay in 140 pregnancies following induction of ovulation with gonadotropins or clomiphene citrate. The levels were compared with those observed in 79 spontaneous pregnancies. Significantly higher levels were observed in gonadotropin and clomiphene citrate induced pregnancies (both P values less than 0.001) between the 6th to 9th week of gestation as compared to spontaneous pregnancies. Steroid levels were similar in the two groups from the 9th week onwards. No statistically significant differences in steroid hormone values were observed in aborted and successful pregnancies within each group studied. We conclude that ovulation induction is associated with higher estradiol and progesterone levels until placental steroidogenesis starts.

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Section: Discussionsupporting

confidence: 63%

Comparison of maternal serum estradiol and progesterone levels in pregnancies after induced and spontaneous ovulation

Hassiakos

Mantzavinos

Kalomiris

et al. 1991

Arch Gynecol Obstet

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“…Whittaker et al [17] observed that hCG was not a sensitive discriminator of the subsequent failure as no significant hormone differ ences were observed in women with/without evidence of fetus. In pregnancies between 6 and 8 weeks which failed subsequently, placental steroid production was reduced or absent but the ability to manufacture hPL and hCG was still present though muted.…”

Section: Resultsmentioning

confidence: 99%

Early Pregnancy Factor as a Marker for Assessing Embryonic Viability in Threatened and Missed Abortions

Shahani¹,

Moniz²,

Bordekar³

et al. 1994

Gynecol Obstet Invest

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It is now well recognized that the presence of early pregnancy factor (EPF) can signify the occurrence of fertilization, continuation of pregnancy and the existence of a viable embryo. With this in view, a study was undertaken to observe the potential of EPF as a marker in assessing embryo viability in cases complicated with vaginal bleeding during early pregnancy. The results indicated that the sensitivity of EPF as a marker in predicting threatened or missed abortion was 78.9% and the specificity 95.6%. The positive predictive value was observed to be 93.8% and the negative predictive value 84.6%. Our studies have shown that since EPF is present in viable but absent in non-viable pregnancies, it could be a useful marker of prognostic value in threatened abortions.

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“…Ultrasound showed that eight women developed an obvious foetus with a detectable heartbeat before EPF, while 25 had a gestational sac but no foetal echoes were ever detected. Clinical details of these 105 women and the hormone assay methods for progesterone, oestradiol, hCG and hPL have been published previously [ 8 ]. At each clinic visit, blood samples were obtained from the women in the morning after an overnight fast.…”

Section: Methodsmentioning

confidence: 99%

“…Few studies have explored the hormonal environment antecedent to symptoms of EPF. We undertook a prospective serial study which measured maternal hormones before, during and after both normal pregnancy and EPF, and have made a reassessment (using up-to-date regression analysis) of our previously published data [ 8 ], to further clarify the possible hormonal associations with poor pregnancy outcome.…”

Section: Introductionmentioning

confidence: 99%

Gestational hormone trajectories and early pregnancy failure: a reassessment

Whittaker

Schreiber

Sammel

2018

Reprod Biol Endocrinol

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BackgroundStudies have commonly assessed the endocrinolgical status of women once miscarriage is threatened or suspected; few studies have explored the antecedent hormonal environment or used a longitudinal strategy. Using refined statistical techniques, we sought to re-evaluate whether gestational hormone trajectories in early pregnancy can identify future miscarriage in asymptomatic pregnancies.MethodsThis prospective cohort study followed 105 women over-conception; 72 had normal term pregnancy outcomes while 33 experienced early pregnancy failure between 35 and 115 days of gestation. Participants attended a pre-conception and antenatal clinic at Newcastle University, United Kingdom (UK). Evaluation methods included ultrasound, clinical assessments of pregnancy progress and serial measurements of gestational hormones by radioimmunoassays. Linear mixed-effects regression analysis examined hormone relationships with pregnancy outcomes.ResultsDetailed longitudinal illustration of gestational hormones, antecedent to miscarriage indications, revealed early pathophysiological trends. In particular, oestradiol showed as marked a deviation from normal as progesterone before miscarriage was evident, reflecting a deficiency in the ovarian response to rising human chorionic gonadotrophin (hCG) levels. Regression analysis provided equations for gestational hormone slopes that significantly differentiated asymptomatic women with subsequent early pregnancy failure, compared to women with normal term pregnancies. Both progesterone and oestradiol displayed negative mean slopes in pregnancies destined for failure; in this group, both human placental lactogen (hPL) and hCG revealed mean positive trajectories that imitated normal pregnancies but at slower rates of increase.ConclusionsOestradiol, progesterone and hCG trajectories, from 50 days of gestation, have good potential for revealing pathophysiology and for identifying which asymptomatic pregnancies are destined for subsequent failure. In asymptomatic patients where there is concern about viability and ultrasound diagnosis is ambiguous, a combined hormonal profile could contribute to guiding patient care decisions.

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Some endocrinological events associated with early pregnancy failure

Cited by 29 publications

References 26 publications

Comparison of maternal serum estradiol and progesterone levels in pregnancies after induced and spontaneous ovulation

Comparison of maternal serum estradiol and progesterone levels in pregnancies after induced and spontaneous ovulation

Early Pregnancy Factor as a Marker for Assessing Embryonic Viability in Threatened and Missed Abortions

Gestational hormone trajectories and early pregnancy failure: a reassessment

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