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

Duan, Lijun; Yan, Denglu; Zeng, Wei; Xiao, Yang; Wei, Qiang

doi:10.1007/s00404-010-1367-7

Cited by 34 publications

(42 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although, Lijun & colleagues concluded that serum progesterone combined with β-hCG measurements, with a diagnostic accuracy of 85.7%, had the best prognostic reliability for predicting the outcome of threatened miscarriage compared to serum progesterone alone or β-hCG alone (Duan et al 2011), Daily and colleagues found that the mean serum progesterone was significantly high for viable pregnancies (22.1 ng/ml) compared to non-viable pregnancies (10.1 ng/ml) and they concluded that a serum progesterone assay alone is predictive of pregnancy outcome specially during the first 8 weeks of gestation (Daily et al 1994), also, Zainab Al Jufairi, found that serum progesterone level was significantly high in patients with viable pregnancies (20.48 ± 6.066 ng/ml) compared with patient with non-viable pregnancies ended by spontaneous abortion (7.78 ± 2.06 ng/ml) and she concluded that the serum progesterone alone is a reliable marker for prediction of early pregnancy failure (Zainab Ali Abdulla Al 2000).…”

Section: Discussionmentioning

confidence: 99%

Relation between single serum progesterone assay and viability of the first trimester pregnancy

Abdelazim¹,

Belal²,

Makhlouf³

2013

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

This study was designed to detect the relation between serum progesterone and viability of pregnancy during the first trimester. Prospective study carried out in Al-Rashid Maternity and Ahmadi Kuwait oil company hospitals, over three years from February 2009 to February 2012. Two hundred and Sixty (260) pregnant women were hospitalized due to vaginal bleeding and/or abdominal pain during the first trimester of their pregnancies and were included in this study. Women included in this study were; sure of dates, conceived spontaneously with no history of infertility and had a positive serum pregnancy test. 2 ml blood samples were taken for women included in this study for serum progesterone assay. Women included in this study were followed by ultrasound for the viability of the pregnancy till the end of first trimester and the outcome of their pregnancy were recorded, while women with exogenous progesterone support or multiple pregnancies or suspected ectopic pregnancy or Hydatiform mole were excluded from this study. Data were collected and statistically analyzed to detect the relationship between serum progesterone level and viability of pregnancy during the first trimester. The mean age of the studied population was 32.7 ± 5.1 years, the mean gestational age at progesterone assay was 9.7 ± 0.5 week and by the end of the first trimester, women included in this study were classified according to the viability of their pregnancies into; viable pregnancy group 178 (68.5%) cases and non-viable pregnancy group (ended by miscarriage) 82 (31.5%) cases. The mean serum progesterone of the studied population was significantly high in viable pregnancy group (46.5 ± 7.4 ng/ml) compared to non-viable pregnancy group (9.9 ± 4.8 ng/ml), (p <0.05). In this study; 6.7% of viable pregnancies had serum progesterone level <10 ng/ ml, while 20.7% of non-viable pregnancies had serum progesterone level >10 ng/ml, the serum progesterone at cut off level 10 ng/ml was 79.3% sensitive to diagnose non-viable pregnancy and was 93.3% specific to diagnose viable pregnancy. Also, in this study; 1.1% of viable pregnancies had serum progesterone level <20 ng/ ml, while 4.8% of non-viable pregnancies had serum progesterone level >20 ng/ml, the serum progesterone at cut off level 20 ng/ml was 95.1% sensitive to diagnose non-viable pregnancy and was 98.9% specific to diagnose viable pregnancy. Serum progesterone is a reliable marker for early pregnancy failure and single assay of its serum level can differentiate between viable and non-viable pregnancies.

show abstract

Section: Discussionmentioning

confidence: 99%

Relation between single serum progesterone assay and viability of the first trimester pregnancy

Abdelazim¹,

Belal²,

Makhlouf³

2013

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

show abstract

“…28,29 The biomarkers that give the best predictive values are a combination of se-rum progesterone and ␤hCG, with a sensitivity of 88.1% and specificity of 84.3%. 30 However, no biomarker of inflammation in the peripheral maternal blood has been validated sufficiently to be of any clinical use in counseling women with TM regarding their risks of subsequent miscarriage and other complications or for providing advice about the benefit of specific treatment to reduce these risks. 31 Recent data have indicated that treatment that corrects Th1/Th2 imbalance, such as dydrogesterone, could help prevent TM from resulting in a full miscarriage.…”

mentioning

confidence: 99%

Pro- and antiinflammatory cytokines in threatened miscarriages

Calleja‐Agius

Muttukrishna

Pizzey

et al. 2011

American Journal of Obstetrics and Gynecology

View full text Add to dashboard Cite

OBJECTIVE:The purpose of this study was to evaluate circulating and intracellular levels of Th1 and Th2 cytokines in women with threatened miscarriage (TM) and subsequent outcome.STUDY DESIGN: Plasma levels of tumor necrosis factor (TNF)-receptors 1 and 2, TNF␣, interferon gamma (IFN␥), and interleukins (IL) -6 and -10 were measured by flow cytometric bead assays in 80 women with TM: 53 women with normal outcome and 27 women who miscarried. Fluorescent antibody labeling was also performed on whole blood in a subgroup of 27 women of TM: 16 women with normal outcome and 11 women who miscarried. RESULTS:Monocyte expression of TNF␣ and circulating levels of TNF␣, IFN␥, IL-10, IL-6, and TNF-R1 were significantly lower, whereas circulating levels of TNF␣/IL-10, IFN␥/IL-10, and TNF␣/IL-6 ratios were significantly higher, in women with TM who subsequently miscarried, compared with the women with normal outcome.CONCLUSION: An increased Th1 type of immune response, which was similar to that observed in preterm delivery, was found in TM cases that were complicated by a subsequent miscarriage.

show abstract

“…At present, there is no reliable marker to predict the clinical outcome of women presenting with TM in the first trimester of pregnancy, although several potential markers have been studied (14,15). Our results indicate that early pregnancy loss is associated with low VEGF expression, and this association possibly originates from the villous cytotrophoblasts, syncytiotrophoblasts and endometrial gland epithelium.…”

Section: Resultsmentioning

confidence: 72%

“…There are a few papers in the literature on maternal serum AFP (MS-AFP) levels in the first trimester (9,10,12,13). Previous studies have shown that the levels of endocrinological factors, such as hCG, progesterone (14,15), pregnancy associated plasma protein-A (PAPP-A) and inhibin A (13) levels, are decreased in the first trimester in patients with symptoms of threatened miscarriage (TM) who subsequently had a complete miscarriage, compared to those with a normal obstetric outcome. The aim of the present study was to detect and compare VEGF immunoreactivity among feto-maternal materials obtained as a result of spontaneous incomplete abortion (IA), intrauterine death (IU-D) and elective termination of pregnancy (control) and to determine the values of first-trimester maternal serum levels of AFP and β-hCG as markers of angiogenesis and predictors of abortion and intrauterine fetal losses.…”

Section: Introductionmentioning

confidence: 99%

Low VEGF expression in conceptus material and maternal serum AFP and levels as indicators of defective angiogenesis in first-trimester miscarriages

Kutluer¹,

Çiçek²,

Moraloğlu³

et al. 2012

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

Low VEGF expression in conceptus material and maternal serum AFP and β-hCG levels as indicators of defective angiogenesis in first-trimester miscarriages Objective: The aims of this study were to assess the relationship between early miscarriages and vascular endothelial growth factor (VEGF) expression and to determine the serum levels of first-trimester maternal alpha-fetoprotein (AFP) and human chorionic gonadotropin (β-hCG) as markers of angiogenesis and predictors of abortion and intrauterine fetal loss. Material and Methods:The present study was a prospective, singlecenter, randomized controlled clinical trial. Ninety-five women who were 6-10 weeks pregnant between May and June 2010 were included in the study. The subjects were divided into three groups, i.e., incomplete abortion (IA) (n=31), intrauterine death (IU-D) (n=32) and control (elective pregnancy termination) (n=32). Feto-placental materials were compared based on immune staining for VEGF in the pathology laboratory, and maternal serum samples were tested in the hormone laboratory.Results: Serum β-hCG levels in the patient groups were significantly lower than the controls (p=0.001). The serum AFP level was lower than the controls in the IA group while it was higher than the controls in the IU-D (p=0.016). Immunohistochemistry showed that the cytotrophoblast, syncytiotrophoblast and endometrial gland epithelium were weakly stained for VEGF in the patient groups (IA and IU-D) in comparison to the control group (p=0.06, p=0.028, p=0.006). Conclusion:Early pregnancy losses are related to insufficient angiogenesis, and maternal serum AFP and β-hCG can be used as markers of angiogenesis in the first trimester.(J Turkish-German Gynecol Assoc 2012; 13: 111-7) Abstract ÖzetOriginal Investigation 111

show abstract

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

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

Cited by 34 publications

References 16 publications

Relation between single serum progesterone assay and viability of the first trimester pregnancy

Relation between single serum progesterone assay and viability of the first trimester pregnancy

Pro- and antiinflammatory cytokines in threatened miscarriages

Low VEGF expression in conceptus material and maternal serum AFP and levels as indicators of defective angiogenesis in first-trimester miscarriages

Contact Info

Product

Resources

About