Prediction of early pregnancy failure with a single progesterone level assessment combined with different transvaginal ultrasound parameters

Abstract EN

Objective: To assess the role and predictive values of a single vaginal ultrasound reading and a single progesterone measurement, in cases of first trimester abortion.

Setting: Al-Azhar and Menofiya Universities, departments of OB/GYN Study design: This was a prospective comparative study, done from the period of July 1998 till March 2000 Subjects and methods: The study included 100 pregnant women, with mild vaginal bleeding in their first trimester of pregnancy.

During the study, patients were divided to two groups, continued group and non-continued group and this was considered as the control group.

10 ml blood sample was taken from patients for serum progesterone level and was measured by using a double antibody radioimmunoassy, after displacement from binding proteins with danazol.

All pregnancies included in the study underwent a real time ultrasound examination.

Examination was done at +10 weeks gestation for all patients, and for those who continued pregnancy rescan was done at +20 and + 28 weeks gestation.

Doppler was done using a vaginal probe at + 10 weeks gestation.

Results: Progesterone levels were lower in the non- continuing group, were P< 0.001, the ultrasound parameters used like the CRL, BPD, had no significant effect on the long-term prognosis P> 0.05, while the MSD and the systolic/ diastolic ratios in the Doppler examination, had a significant effect on the long term, prognosis P, and 0.05.

FHR had a high significant effect on the long-term prognosis P< 0.001.

Conclusion: We concluded from this that the single progesterone measurement in combination with the transvaginal ultrasound to measure the FHR and MSD, and the transvaginal Doppler examination for the A/B ratio if used in combination, had a good statistical significance in the immediate diagnosis of early pregnancy failure and the long term prognosis of viability.

These two parameters should not be looked upon as alternatives, as many studies previously suggested, but rather complementary procedures.

This may have an important early implication on the management of early pregnancy bleeding and the cost of hospital stay.