The diagnostic value of β-human chorionic gonadotropin, progesterone, CA125 in the prediction of abortions

Abstract

This study was conducted to investigate the effectiveness of serum levels of free beta-hCG, progesterone, CA125 and their combined use in the prediction of first trimester abortions. A total of 140 singleton pregnant women between 5 and 13 weeks' gestational age were included as Group I (n = 21) who resulted in abortion including missed abortion, incomplete abortion, complete abortion and inevitable abortion; Group II (n = 129) included normal pregnancies. When using the free beta-hCG level of <20 ng/ml as a cut off point, the sensitivity, specificity, PPV and NPV were 91%, 82%, 46% and 98%, when using a progesterone of <15 ng/ml as a cut off point, they were 91%, 89%, 59%, 98%. The single measurement of free beta-hCG or progesterone levels can be useful in the prediction of first trimester spontaneous abortions, but using progesterone may be recommended since it has high availability and low cost.

First-trimester reference ranges for decidual thickness and its relation to progesterone levels

“…When a value of 15 ng/mL was set as the cutoff point for progesterone [21] , 91 patients had < 15 ng/mL and 82 had ≥ 15 ng/mL progesterone level. Median age of patients with < 15 ng/mL progesterone level and ≥ 15 ng/mL progesterone level was 28 (6) and 28.5 (6) years, respectively.…”

“…Several potential ultrasonographic and endocrinologic markers have been previously investigated for predicting pregnancy loss [2,14,19,21,24] . However, a novel ultrasonographic marker called " decidual thickness " has been recommended to discriminate women with pregnancy loss from those with healthy pregnancy [24] .…”

“…Serum progesterone level is one of the most studied markers for predicting pregnancy loss in the literature [2,3,10,21] . As is known, progesterone is indispensable for the establishment and maintenance of pregnancy.…”

“…Several potential endocrinologic and ultrasonographic markers, such as human chorionic gonadotrophin (hCG), progesterone [2,19,21] , PAPP-A, and inhibin A [14] have been evaluated to predict pregnancy loss, but confl icting results have been reported. Therefore, recent efforts have been focused on the discovery of new predictive markers or a de novo combination of previous markers.…”

Progesterone combined with beta human chorionic gonadotropin measurements and threatened miscarriage

“…Finally, although either progesterone or b-HCG measurements can be used for prediction of abortion the concern on cost of the laboratory test is required. Based on the mentioned facts, it is suggested that single progesterone test is more proper due to lower cost and easier availability [7]. As a summary, this letter raises an important laboratory concern on using progesterone and beta human chorionic gonadotropin measurements in predicting the natural course of threatened miscarriage.…”