Serial hCG and progesterone levels to predict early pregnancy outcomes in pregnancies of uncertain viability: A prospective study

Puget, Claire; Joueidi, Yolaine; Bauville, Estelle; Laviolle, Bruno; Bendavid, Claude; Lavoué, Vincent; Lous, Maëla Le

doi:10.1016/j.ejogrb.2017.11.020

Cited by 26 publications

(26 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The number of viable pregnancies was signi cantly reduced in the low β-HCG group. An additional study demonstrated that a ratio of HCG 48h/0h <11% was related to early pregnancy loss [10], while a ratio >75% was related to 100% surviving pregnancy.…”

Section: Discussionmentioning

confidence: 97%

“…Progesterone <11.5 ng/ml predicted abortion with an overall accuracy of 99.8%. Puget [10] found that the sensitivity, speci city, and positive and negative predictive values of a 6.2 ng/ml progesterone level in diagnosing early pregnancy loss were 20%, 100%, 100%, and 65.2%, respectively. Ver Haegen reported that when the threshold was 10 ng/mL [14], the sensitivity for predicting infeasible pregnancy was 66.5%, and the speci city was 96.3%.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

the Forecast of Weekly β-HCG and Progesterone for Early Pregnancy

Yang

Duan

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Serum beta human chorionic gonadotropin (β-HCG) and progesterone levels are both monitored to assess the status of early pregnancy. Deviations from the expected levels of these hormones may indicate abnormal pregnancy. However; the relationship between progesterone levels and the magnitude of weekly β-HCG increases, as well as their combined predictive value for pregnancy outcome, is still debated. This study evaluated the predictive value of weekly serum β-HCG multiplication and progesterone levels on early pregnancy outcomes. Methods: This retrospective study reviewed patients with pregnancy confirmed by β-HCG in our hospital. Weekly β-HCG and progesterone levels were analyzed and ultrasonography was performed as necessary to determine outcomes at 13 weeks gestation. Results: There were 277 viable intrauterine pregnancies, 102 spontaneous abortions, and 59 ectopic pregnancies. At weeks 5-8, β-HCG was multiplied by 6.76, 6.21, 2.11, and 0.68 respectively. Logit models were established with the logarithm of HCG (LHCG) and progesterone as independent variables to predict viable intrauterine pregnancy. The sensitivity, specificity, and overall accuracy for the models were 85.9% and 90.25%, 44.72% and 72.04%, and 70.77% and 83.6%, respectively. When progesterone was ≥10 ng/ml, the sensitivity and specificity for predicting viable pregnancy were 90.25% and 72.04%, respectively. When progesterone was <10 ng/ml, the sensitivity and specificity for predicting ectopic pregnancy and complete abortion were 94.2% and 81.57%78.86%, respectively. Progesterone values were significantly different for viable pregnancy, abortion, and ectopic pregnancy (p<0.0001). A joint progesterone and LHCG model to predict viable pregnancy had 88.8% sensitivity, 75.2% specificity, and 83.8% overall prediction accuracy.Conclusion: Weekly β-HCG multiplication and progesterone levels can predict early pregnancy outcomes individually or jointly.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

the Forecast of Weekly β-HCG and Progesterone for Early Pregnancy

Yang

Duan

Wang

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The number of viable pregnancies was significantly reduced in the low β-HCG group. An additional study demonstrated that a ratio of HCG 48h/0h <11% was related to early pregnancy loss [10], while a ratio >75% was related to 100% surviving pregnancy.…”

Section: Discussionmentioning

confidence: 97%

“…Progesterone <11.5 ng/ml predicted abortion with an overall accuracy of 99.8%. Puget [10] found that the sensitivity, specificity, and positive and negative predictive values of a 6.2 ng/ml progesterone level in diagnosing early pregnancy loss were 20%, 100%, 100%, and 65.2%, respectively. Ver Haegen reported that when the threshold was 10 ng/mL [14], the sensitivity for predicting infeasible pregnancy was 66.5%, and the specificity was 96.3%.…”

Section: Discussionmentioning

confidence: 99%

the Forecast of Weekly β-HCG and Progesterone for Early Pregnancy

Yang¹,

Duan²,

Yan³

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: Serum beta human chorionic gonadotropin (β-HCG) and progesterone levels are both monitored to assess the status of early pregnancy. Deviations from the expected levels of these hormones may indicate abnormal pregnancy. However; the relationship between progesterone levels and the magnitude of weekly β-HCG increases, as well as their combined predictive value for pregnancy outcome, is still debated. This study evaluated the predictive value of weekly serum β-HCG multiplication and progesterone levels on early pregnancy outcomes. Methods: This retrospective study reviewed patients with pregnancy confirmed by β-HCG in our hospital. Weekly β-HCG and progesterone levels were analyzed and ultrasonography was performed as necessary to determine outcomes at 13 weeks gestation. Results: There were 277 viable intrauterine pregnancies, 102 spontaneous abortions, and 59 ectopic pregnancies. At weeks 5-8, β-HCG was multiplied by 6.76, 6.21, 2.11, and 0.68 respectively. Logit models were established with the logarithm of HCG (LHCG) and progesterone as independent variables to predict viable intrauterine pregnancy. The sensitivity, specificity, and overall accuracy for the models were 85.9% and 90.3%, 44.72% and 72%, and 70.77% and 83.6%, respectively. When progesterone was ≥10 ng/ml, the sensitivity and specificity for predicting viable pregnancy were 90.25% and 72.04%, respectively. When progesterone was <10 ng/ml, the sensitivity and specificity for predicting ectopic pregnancy and complete abortion were 94.2% and 81.57%, respectively. Progesterone values were significantly different for viable pregnancy, abortion, and ectopic pregnancy (p<0.0001). A joint progesterone and LHCG model to predict viable pregnancy had 88.8% sensitivity, 75.2% specificity, and 83.8% overall prediction accuracy. Conclusion: Weekly β-HCG multiplication and progesterone levels can predict early pregnancy outcomes individually or jointly.

show abstract

“…hCG and progesterone were analyzed concomitantly to determine whether their levels would be able to rapidly predict whether or not doubtful early pregnancy will continue, and the results provided a 48-h diagnosis of viability in 41.1% of patients (172). Another study shows that hCG and progesterone levels 14 days after oocyte retrieval may be predictive for continued pregnancy in patients with recurrent miscarriages (173).…”

Section: Hcg and Miscarriagesmentioning

confidence: 99%

Human Chorionic Gonadotrophin: New Pleiotropic Functions for an “Old” Hormone During Pregnancy

et al. 2020

View full text Add to dashboard Cite

Human chorionic gonadotrophin (hCG) is the first specific molecule synthesized by the embryo. hCG RNA is transcribed as early as the eight-cell stage, and the blastocyst produces the protein before its implantation. hCG in the uterine microenvironment binds with its cognate receptor, luteinizing hormone/choriogonadotropin receptor (LHCGR), on the endometrial surface. This binding stimulates leukemia inhibitory factor (LIF) production and inhibits interleukin-6 (IL-6) production by epithelial cells of the endometrium. These effects ensure essential help in the preparation of the endometrium for initial embryo implantation. hCG also effects angiogenic and immunomodulatory actions as reported in many articles by our laboratories and other ones. By stimulating angiogenesis and vasculogenesis, hCG provides the placenta with an adequate maternal blood supply and optimal embryo nutrition during the invasion of the uterine endometrium. The immunomodulatory properties of hCG are numerous and important for programming maternal immune tolerance toward the embryo. The reported effects of hCG on uterine NK, Treg, and B cells, three major cell populations for the maintenance of pregnancy, demonstrate the role of this embryonic signal as a crucial immune regulator in the course of pregnancy. Human embryo rejection for hCG-related immunological reasons has been studied in different ways, and a sufficient dose of hCG seems to be necessary to maintain maternal tolerance. Different teams have studied the addition of hCG in patients suffering from recurrent miscarriages or implantation failures. hCG could also have a beneficial or a negative impact on autoimmune diseases during pregnancy. In this review, we will discuss the immunological impacts of hCG during pregnancy and if this hormone might be used therapeutically.

show abstract

Serial hCG and progesterone levels to predict early pregnancy outcomes in pregnancies of uncertain viability: A prospective study

Cited by 26 publications

References 23 publications

the Forecast of Weekly β-HCG and Progesterone for Early Pregnancy

the Forecast of Weekly β-HCG and Progesterone for Early Pregnancy

the Forecast of Weekly β-HCG and Progesterone for Early Pregnancy

Human Chorionic Gonadotrophin: New Pleiotropic Functions for an “Old” Hormone During Pregnancy

Contact Info

Product

Resources

About