The Accuracy of Single Progesterone, Single β-hCG, and Their Combination Measurement in Predicting Early Miscarriage: A Prospective Study in Outpatient Setting

KnE Medicine ◽  
2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Eli Sia
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Good Predictor ◽  
First Trimester ◽  
Outpatient Setting ◽  
Maternal Serum ◽  
Serum Progesterone ◽  
First Trimester Of Pregnancy ◽  
Β Hcg ◽  
A Prospective Study

<p><strong>Introduction:</strong> Most of miscarriage events occurred during the first trimester of pregnancy. Recent studies found the beneficial effects of maternal serum markers to predict pregnancy outcomes. However, study in Indonesian setting was still limited, especially in outpatient setting. The aim of this study was to evaluate serum progesterone and β-hCG measurement  as a beneficial predictor of miscarriage.</p><p><strong>Materials &amp; Methods:</strong> This was a prospective study recruiting outpatients pregnant women in Aceh who seek first medical attention for their pregnancy during January 2013 to January 2015. Serum progesterone and β-hCG level were measured beside routine obstetric procedure. The discrimination attained between miscarriage and non-miscarriage groups of pregnant women at the end of first trimester was evaluated using logistic regression and receiver operating curve analysis.</p><p><strong>Results: </strong>Among 70 pregnant recruited in this study, nineteen of them (27.1%) experienced miscarriage. Serum progesterone level of women in miscarriage group was lower than non-miscarriage group (17.85 (IQR 13.26-21.15) ng/dl vs 33.67 (IQR 21.83-44.14), p&lt;0.001). Serum β-hCG level was also lower in miscarriage group (10 681 (IQR 5 787.5-26 577.5) mIU/ml vs 48 109 (IQR 17 137-93 915) mIU/ml, p=0.001). Single progesterone measurement gave a good predictor ability for miscarriage with 82.2% accuracy, 86.3% sensitivity and 73.7% specificity if 19.5 ng/dl was used as a cut-off point.</p><strong>Conclusion: </strong>Maternal serum progesterone level could be a good predictor for miscarriage during the first trimester of pregnancy. Single β-hCG serum in combination with progesterone serum measurement only had little added value for predicting miscarriage.

Human chorionic gonadotrophin and subunit composition of maternal serum and coelomic and amniotic fluids in the first trimester of pregnancy

1992 ◽  
Vol 135 (3) ◽  
pp. 563-569 ◽  
Author(s):  
R. K. Iles ◽  
N. C. Wathen ◽  
D. J. Campbell ◽  
T. Chard
Keyword(s):  
First Trimester ◽  
Maternal Serum ◽  
Chorionic Gonadotrophin ◽  
Human Chorionic Gonadotrophin ◽  
Subunit Composition ◽  
Major Constituent ◽  
Coelomic Fluid ◽  
Α Subunit ◽  
First Trimester Of Pregnancy ◽  
Β Hcg

ABSTRACT Sixteen matched samples of first trimester amniotic fluid (AF), extraembryonic coelomic fluid (EECF) and maternal serum (MS) were assayed for intact human chorionic gonadotrophin (hCG) and free subunits. Total β-hCG (free β-subunit and intact hCG) levels in the EECF (median 410 kIU/l) were 61 times greater than levels in AF (median 6·73 kIU/l) and 2·8 times greater than in MS (median 141·5 kIU/l). Levels of intact hCG in the EECF (median 245 kIU/l) were 142 times greater than in AF (median 1·73 kIU/l) and 1·6 times greater than in MS (median 157 kIU/l). Free α-subunit levels in EECF (median 17·3 mg/l) were 66 times greater than in AF (median 0·262 mg/l) and 12 times greater than in MS (median 1·3 mg/l). Virtually all of the total β-hCG immunoreactivity in MS can be attributed to intact hCG, but only 60% of total β-hCG in the EECF and 20% of that in AF can be accounted for by the intact hormone. In both EECF and AF the free α-subunit was a major constituent; on a molar basis the ratio of free α:free β:intact hCG was 1:1·2:0·3 in AF, 1:0·6:0·5 in EECF and 1:0:5 in MS. Chromatography of MS, EECF and AF on Sephadex G-100 confirmed the hCG and subunit composition of the fluids. On the basis of these findings it seems likely that previous studies showing very high levels of hCG in AF during the first trimester may have incorrectly sampled the EECF. In reality, the levels of total hCG (and free subunits) are low in the AF, and only 20% is intact hCG. In both AF and EECF the free subunits may have been derived by dissociation of intact hormone, or possibly by independent synthesis. These and other findings suggest that either the amnion acts as a barrier to the transfer of proteins or that there may be dynamic removal from this compartment. By contrast, the EECF might act as a relatively stable reservoir for these proteins. Journal of Endocrinology (1992) 135, 563–569

scholarly journals Biochemical Markers for Prediction of Pregnancy Outcome in Cases of Recurrent Pregnancy Loss

2021 ◽  
Vol 5 (1) ◽  
Keyword(s):  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
First Trimester ◽  
Serum Progesterone ◽  
Study Results ◽  
Routine Basis ◽  
History Of ◽  
Β Hcg

Objective: To predict pregnancy outcome by studying the relation between serum βHCG, progesterone and CA125 and the occurrence of miscarriage in the first trimester, in cases with history of recurrent pregnancy loss. Methods: Serum βHCG, progesterone and CA125 levels in fifty pregnant women with history of recurrent pregnancy loss were compared to 50 pregnant women with no history of abortion, and to another group of women (No=50) who failed to complete the 1st trimester of pregnancy during the study. Results: Serum B-hCG showed a sensitivity of 100%, a specificity of 50%, a PPV of 50% and a NPV of 100%. Serum progesterone showed a sensitivity of 24%, a specificity of 73%, a PPV of 55.07% and a NPV of 85.18%, while serum CA125 showed a sensitivity of 15.6%, a specificity of 58.59%, a PPV of 16.32% and a NPV of 57.42%. Conclusion: The value of CA125 in recurrent abortions is still unclear and cannot recommended on routine basis. On the other hand, β-HCG is highly sensitive as a single serum measurement for the prediction of pregnancy outcome.

scholarly journals Day 14 maternal serum progesterone levels predict pregnancy outcome in IVF/ICSI treatment cycles: a prospective study

2005 ◽  
Vol 20 (3) ◽  
pp. 741-746 ◽  
Author(s):  
G. Ioannidis ◽  
G. Sacks ◽  
N. Reddy ◽  
L. Seyani ◽  
R. Margara ◽  
...  
Keyword(s):  
Prospective Study ◽  
Pregnancy Outcome ◽  
Maternal Serum ◽  
Serum Progesterone ◽  
A Prospective Study

scholarly journals First Trimester Combined Test (FTCT) as a Predictor of Gestational Diabetes Mellitus

2019 ◽  
Vol 16 (19) ◽  
pp. 3654 ◽  
Author(s):  
Federica Visconti ◽  
Paola Quaresima ◽  
Eusebio Chiefari ◽  
Patrizia Caroleo ◽  
Biagio Arcidiacono ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Logistic Regression ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
First Trimester ◽  
Maternal Serum ◽  
Fetal Aneuploidy ◽  
Combined Test ◽  
Β Hcg

Background—The first trimester combined test (FTCT) is an effective screening tool to estimate the risk of fetal aneuploidy. It is obtained by the combination of maternal age, ultrasound fetal nuchal translucency (NT) measurement, and the maternal serum markers free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein A (PAPP-A). However, conflicting data have been reported about the association of FTCT, β-hCG, or PAPP-A with the subsequent diagnosis of gestational diabetes mellitus (GDM). Research design and methods—2410 consecutive singleton pregnant women were retrospectively enrolled in Calabria, Southern Italy. All participants underwent examinations for FTCT at 11–13 weeks (plus 6 days) of gestation, and screening for GDM at 16–18 and/or 24–28 weeks of gestation, in accordance with current Italian guidelines and the International Association Diabetes Pregnancy Study Groups (IADPSG) glycemic cut-offs. Data were examined by univariate and logistic regression analyses. Results—1814 (75.3%) pregnant women were normal glucose tolerant, while 596 (24.7%) were diagnosed with GDM. Spearman univariate analysis demonstrated a correlation between FTCT values and subsequent GDM diagnosis (ρ = 0.048, p = 0.018). The logistic regression analysis showed that women with a FTCT <1:10000 had a major GDM risk (p = 0.016), similar to women with a PAPP-A <1 multiple of the expected normal median (MoM, p = 0.014). Conversely, women with β-hCG ≥2.0 MoM had a reduced risk of GDM (p = 0.014). Conclusions—Our findings indicate that GDM susceptibility increases with fetal aneuploidy risk, and that FTCT and its related maternal serum parameters can be used as early predictors of GDM.

scholarly journals Preeclampsia and level of oxidative stress in the first trimester of pregnancy

2017 ◽  
Vol 74 (7) ◽  
pp. 633-638 ◽  
Author(s):  
Mirjana Bogavac ◽  
Ana Jakovljevic ◽  
Zoran Stajic ◽  
Aleksandra Nikolic ◽  
Mirjana Milosevic-Tosic ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Pregnant Women ◽  
Total Antioxidant Status ◽  
First Trimester ◽  
Normal Pregnancy ◽  
Clinical Syndrome ◽  
Control Group ◽  
Study Group ◽  
First Trimester Of Pregnancy ◽  
A Prospective Study

Background/Aim. Preeclampsia (PE) is a multisystemic syndrome that complicates 5?8% of all pregnancies. The aim of this study was to evaluate the biochemical parameters of oxidative stress in the first trimester of pregnancy in patients with preeclampsia, with the purpose of comparing the level of oxidative stress with normal pregnancy. Methods. The study was conducted as a prospective study. It included totally 107 pregnant women divided into two groups. In the study group (n = 33) there were women who developed preeclampsia in the current pregnancy. The control group (n = 74) included healthy pregnant women. Blood samples were taken between 11th and 14th weeks of gestation, and the values of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and total antioxidant status (TAS) were determined in serum by enzymatic colorimetric methods. Results. The values of SOD and GHS-Px were statistically higher in the study group, while the values of TAS were statistically higher in the control group. The level of TAS inversely correlated with GSH-Px and SOD, but there is no statistically significant correlation between GSHPx and SOD in the study group. Conclusion. The results of this study suggest a higher level of oxidative stress in the first trimester of pregnancy with preeclampsia, which may indicate that the initiation and development of pathophysiological processes underlying preeclampsia start much earlier than the clinical syndrome exhibit.

scholarly journals BASIC CLINICAL AND PATHOGENETIC ASPECTS OF DEVELOPING THE COMPLICATIONS DURING MULTIPLE PREGNANCIES

2019 ◽  
Vol 72 (1) ◽  
pp. 52-55
Author(s):  
Volodymyr I. Boiko ◽  
Alla V. Boychuk ◽  
Irina M. Nikitina ◽  
Tetyana V. Babar ◽  
Alesya V. Boiko ◽  
...  
Keyword(s):  
Growth Factor ◽  
Pregnant Women ◽  
Solid Phase ◽  
First Trimester ◽  
Enzyme Analysis ◽  
Control Group ◽  
Multiple Pregnancies ◽  
Placental Dysfunction ◽  
First Trimester Of Pregnancy ◽  
A Prospective Study

Introduction: In order to evaluate the value of the Placenta Growth Factor (PlGF) in the developing the gestational complications during multiple pregnancies, a study of this indicator in serum of 320 pregnant women with multiple pregnancies in the first trimester, as well as 40 pregnant women with single pregnancy, constituted a control group. The aim: of the study is to investigate the effect of the placental growth factors on gestational process during multiple pregnancies. Materials and methods: A prospective study of maternity pregnancy in 320 females with multiple pregnancies was conducted, which comprised the main group of the subjects and 40 healthy women with unipolar pregnancy. The level of PlGF in serum was determined by solid phase enzyme analysis using monoclonal antibody sets in the first trimester of pregnancy. Indicators of the hemostasis system (vascular thrombocyte and coagulation link) were evaluated according to generally accepted methods. Dopplerometry of placental and fetal blood flow was performed in uterine arteries, arteries and umbilical cord veins, middle cerebral artery of the fetus. Results: Women with multiple pregnancies are at the risk of gestational complications - premature births in 67.8% (p <0.01), feto placental dysfunction, pre eclampsia - in 17.5% (p <0.05) cases. The revealed violations of the vascular thrombocyte and coagulation homeostasis in the first trimester of pregnancy are the main risk factors for early premature abortion. It has been shown that the low level of placental growth factor in serum of pregnant women with multiple pregnancies in the case of premature labor, feto placental dysfunction and pre-eclampsia (111.23 ± 8.4, 203.24 ± 6.4 and 305.86 ± 7.4 pg / ml) compared with the corresponding indicators for single-pregnancy (418.2 ± 10.4 pg / ml) is a prognostic marker for the development of gestational complications. Conclusions: Timely medical correction of gestational complications during multiple pregnancies with the use of micronized progesterone, low molecular weight heparins, angio protectants allowed prolonging the pregnancy with mono choric type of placentation by 3.2 weeks (up to 34.2 ± 2.4 weeks), and in the case of dichoric twins - to full-term pregnancy.

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