Use of single serum progesterone level measurement as a predictor of the fetal viability during the first trimester
Background and objective: Approximately one in third of pregnant women experience discomfort, pain and or vaginal bleeding during the first trimester of pregnancy. Ultrasound is known to be a useful tool in detecting and diagnosing the viability of the fetus but it is sometimes inconclusive. In cases in which pregnant women experience symptoms of discomfort, serum progesterone may be admitted to the patient for counseling and prediction of the continuity of pregnancy. This study aimed to estimate the relation between single serum progesterone level and the viability of the fetus during the first trimester.
Method: A prospective study was carried out in Maternity teaching hospital-Erbil city to estimate the accuracy of single serum progesterone measurement for the prediction of fetal viability at the end of the first trimester. All the cases have been detected by ultrasound device that has been for women who attended the hospital and reported the feeling of discomfort, pain and bleeding early in the first trimester of pregnancy, serum progesterone level of the patients were compared between viable and nonviable fetuses.
Results: A total of 97 participants were involved in this study; 57 participants had a viable pregnancy at the end of the first trimester, and 40 participants had un-viable pregnancy that has been terminated either by spontaneous abortion or termination performed for missed abortion. The mean of serum progesterone level in viable pregnancies was (19.358 ng\ml) when compared with the non-viable pregnancies which were (11.082 ng\ml). The differences were statistically significant (P <0.001). The cut-off value (13.68ng\ml) provides the highest sensitivity and specificity.
Conclusion: A single serum progesterone measurement was regarded as a reliable test for the prediction of viable and non-viable pregnancy in women who reported to be experiencing pain and bleeding in the early trimester of pregnancy with or with inconclusive ultrasound.
Jorine V, Ioannis D, Norah M. Accuracy of single progesterone test to predict early pregnancy outcome in women with pain or bleeding: the meta-analysis of cohort studies. BMJ 2012; 345:e6077.
Everett C. Incidence and outcome of bleeding before the 20th week of pregnancy: prospective study from general practice. BMJ 1997; 315:32–4.
Ultrasound diagnosis of early pregnancy miscarriage. Clinical practice guideline. Institute of obstetrics and gynecology, royal college of the physician of Ireland and directorate of quality and clinical care. Version 1, Guideline no.1; 2010. (Accessed July 11, 2016, at https://www.hse.ie/eng/services/publications/corporate/ultrasounddiagnosisofearlypregnancymiscarriage.pdf)
Anne ML, Beth P. Diagnosis and management of ectopic pregnancy. Am Fam Physician 2005; 72(9):1707–14.
Gary CF, Kenneth J. Spontaneous abortion. William obstetrics, 21st ed. New York, NY: McGraw-Hill Professional; 2001.
Davies S, Byrn F, Cole LA. Human chorionic gonadotropin testing for early pregnancy viability and complications. Clin Lab Med 2003; 23(2):257–64.
Elson J, Jurkovic D. Biochemistry in diagnosis & management of abnormal early pregnancy. Cur Opin Obstet Gynecol 2004; 16(4):339–44.
Alexandros S, Stefania P. Threatened miscarriage: evaluation and management. BMJ 2004; 329(7458):152–5.
Edwar ZK, Mahasin MA, SurorA. The value of early pregnancy single serum progesterone measurement in relation to the first-trimester viability. Thi-Qar Med J 2011; 5(2):133–41.
Hanita O, Hanisah AH. The potential use of single measurement of serum progesterone in detecting early pregnancy failure. Malaysian J Pathol 2012; 34(1):41–6.
Ibrahim AA, Maha MB, Hanan HM. The relation between single serum progesterone assay and viability of the first-trimester pregnancy. J Turk Ger Gynecol Assoc 2013; 14(2):68–71.
Sandra A, John EB. Current concept: Ectopic pregnancy. New Engl J Med 1993; 329:1174–81.
Hahlin M, Sjoblom P, Lindblom B. Combined use of serum progesterone and human chorionic gonadotrophin determination for differential diagnosis of very early pregnancy.Fertility and Sterility. Elsiver 1991; 55(3):492–6.
Celine A, Shery LL. The prognostic value of serum progesterone and quantitative beta –human chorionic gonadotrophin in early human pregnancy. Am J Obstet Gynecol 1994; 171(2): 380–4.
Al Jufairi ZAA. The value of serum progesterone measurement in early pregnancy. Bahrain Med Bull 2000; 22(3):1.
AlSebai MA, Kingsland CR, Diver M, Hipkin L, McFadyen IR. The role of a single progesterone measurement in the diagnosis of early pregnancy failure and the prognosis of fetal viability. Br J Obstet Gynecol 1995; 102(5):364–9.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Zanco J Med Sci is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).