Diagnostic Efficacy of a Single Progesterone Determination to Assess Full‐Term Pregnancy in the Bitch

Abstract

In clinical settings, when the reproductive history of a near-term bitch is limited to mating dates, the possibility to accurately assess whether pregnancy is at term could be very useful in order to be able to plan a correct management of parturition or to safely perform an elective Caesarean section. The aim of this study was to assess the diagnostic efficacy of a single progesterone determination, measured by chemiluminescent immunoassay (CLIA), in predicting the occurrence of parturition on the following day. At least one blood sample was collected from 51 pre-partum bitches during the 3 days before parturition and on day of parturition. The efficacy of progesterone as a marker of the end of pregnancy was tested using a receiver operating characteristic (ROC) analysis. Youden's index was calculated to select the optimal cut-off value (with 95% confidence interval), aiming at maximizing the correct identification of negative events, so not to risk to diagnose as full term a bitch which is not. Progesterone concentration lower than 3.4 ng/ml correctly identified the bitches whelping the following day; however, because of the obliged prudential approach, sensitivity was low (46.88%), and 17 of 32 full-term bitches were missed. Due to a very large individual variation, a single progesterone determination has low diagnostic efficacy, although it can represent a useful first screening.

The precision of predicting the time of onset of parturition in the bitch using the level of progesterone in plasma during the preparturient period

“…Our study concurs with that of Rota et al (2015) in which they concluded that -Due to a very large individual variation [with respect to the interval between reaching a specific level of progesterone in their serum and parturition], a single progesterone determination has low diagnostic efficacy, although it can represent a useful first screening‖ [43]. Given the limitations of the current study, its results justifies future research as follows to assess the general applicability of its findings in bitches of a variety of breeds carrying litters larger than one where the time of spontaneous cervical dilatation (TCD) has to be identified to the nearest six hours by means of PL in conjunction with vaginal speculum examination: If the cervix of a bitch in late gestation is still closed her PL is immediately measured.…”

Evaluation of serum C-reactive protein concentration as a marker of impending parturition and correlation with progesterone profile in peri-partum bitches

“…Serum progesterone concentrations towards the end of pregnancy can help clinicians to assess impending canine parturition (Rota et al, 2015;De Cramer and Nöthling, 2018), but our data show that the progesterone concentrations are not significantly different in the last three days of pregnancy. Other easy-to measure serum parameters could be useful to increase the accuracy of the diagnosis and CRP, that can be assayed in any facility having instruments for biochemistry serum analysis, could have represented an option.…”

“…A precise prediction of impending parturition could be very useful in order to avoid long observation periods and it is critical when planning a cesarean section. Serum progesterone concentration declines towards the end of pregnancy (Onclin and Verstegen, 1997) and some cut-off values have been calculated; when P is lower than the cut-of value, parturition is likely to occur within a given time interval (Rota et al, 2015;De Cramer and Nöthling, 2018).…”

“…However, large individual variability exists in progesterone concentration, particularly in the last days of pregnancy (Rota et al, 2015;De Cramer and Nöthling, 2018), and other easily measurable parameters that could mark the end of pregnancy would be very useful in clinical practice.…”

Comparing the values of progesterone in the blood of bitches as measured with a chemiluminescence immunoassay and a radioimmunoassay

“…During the past 14 years, papers appeared that report studies in which a chemiluminescent immunoassay (Immulite), abbreviated as CLIA, has been used for measuring progesterone in the serum of bitches (Chapwanya, Clegg, Stanley, & Vaughan, 2008;Kutzler et al, 2003;Rota, Charles, Starvaggi Cucuzza, & Pregel, 2015;Schmicke et al, 2016;Volkmann, 2006).…”