THE VALUE OF EARLY PREGNANCY SINGLE SERUM PROGESTERONE MEASUREMENT IN RELATION TO THE FIRST TRIMESTER VIABILITY
Abstract
The diagnosis of pregnancy require a multi factorial approach using three main diagnostic test, these are: clinical , laboratory & ultrasound examination. There is no single test currently available which immediately differentiate continuing from non continuing intra uterine or tubal pregnancy(1). Aim of the study To assess the use of single serum progesterone measurement in early pregnancy and its relation to the 1st trimester fetal viability. Patients and methods A prospective study conducted in Basrah maternity and child hospital to assess and predict 1st trimester fetal viability using a single serum progesterone measurement for women who attend the hospital either as their 1st antenatal booking or hospitalization for vaginal bleeding or abdominal pain whom were followed for the end of 13th week of gestation and progesterone levels were compared to the fetal viability using ultrasound examination and results were analyzed statistically. Result The study group enrolled 78 pregnancies, 44 pregnancies had continue viable till 13th week of pregnancy and 34 ended with spontaneous abortion. Serum progesterone level was 5.7+10.9 in continuing pregnancy and 6.7+4.8 in spontaneous abortion. The difference progesterone level was highly significant (p value<0.0001). Conclusion Serum progesterone measurement is a reliable biochemical test in establishing the diagnosis of early pregnancy failure and a predictive test for pregnancy continuation.References
Al sebai MAH,Kingsland CR , Diver M.et al.The rule of a single progesterone measurement in the diagnosis of early pregnancy failure in the progress of fetal viability.Br J obstetrics & gynecology 1995;102:364_69.
Nyberg DA ,Mack,Jeffrey,et al.Endovaginal sonographic evaluation of ectopic pregnancy :A prospective study.AJR 1987;149:1181_6.
al sebai MAH,Diver M,Hipkinl.the rule of a single progesterone measurement in the diagnosis of early pregnancy failure& the prognosis of fetal viability.[correspondence],Br J. obstetrics & gynecology 1996;103:391.
Joanne Topping and Roy G. Farquarson (spontaneous miscarriage), Role of us , and us feature in early pregnancy loss classification , diagnosis of miscarriage ,Dewhurst̕s text book of obstet. And Gynaec. Seventh edition . 2007 . ch . 12. P. 94- 98.
-F. Gary Cunningham, Kenneth et al, spontaneous abortion. William, obstetric 2nd edition p 232, 2005.
Ellison,"progesterone",saliva as diagnostic fluid.ANAS 1993;694.p 165_173.
Kaull A,Negamani M,Nowicki B.Decreased expression of endometrial decay factor (DAF),a complement regulatory protein in patient with luteal phase defect. A JRI 1995;34.p236_240.
Strignini FAL, et al, modifications in uterine and intraovarian artery impedance in cycle of treatment with exogenous gonadotrophin effect of luteal phase support .Fort-Sterol .1995,64.p76-80.
. D.K . EDMONDS : intersexuality , Dewhurst,s Text book of obstet. and Gynaeco 5th edition . 1995 , p.14 .
Elson J &Jurkovic D(2004) biochemistry in diagnosis & management of abnormal early pregnancy.Cur.opin obstet. Gyaencol. 16,339_44.
Davies S, Byrn F, Cole LA.Human chorionic gonadotropin testing for early pregnancy viability & complications.Lab mel. Jun 2003(2):257_64. Vil[medline].
Stovall TG,Ling FW, Coop BJ, et al , preventing rupture ectopic pregnancy with a single serum progesterone , Am J obstet. Gyaencol. 1989;160:1425-31.
Gelder MS, Bats LR, Young JB.use of single random serum progesterone levels in normal & abnormal early human pregnancy.Fertil. Steril 1990;54:537_8.
-Carcor SA, Bustr J.Current concept: ectopic pregnancy. The new England J.med.1993;329:1174-8.
-Hahlin M, wallin A, Sjoblom p, et al. single progesterone assay for early recognition of abnormal pregnancy . Hum Reprod 1990;5:622-6.
- Saver MV , Sinosich MJ , Yeko TR, et al. predictive value of a single serum pregnancy associated plasma protein A or progesterone in the diagnosis of abnormal pregnancy .Hum Reprod 1989;4:331-4.
- Hahlin M, Sjoplom p,Lindblom P. Combined use of progesterone and human chorionic gonadotrophin determination for differential diagnosis of very early pregnancy.Fertil Steril 1991;55:492-6.
-Stovall TG,Ling FW, Carson SA, et al . Serum progesterone and uterine curettage in differential diagnosis of ectopic pregnancy .Fertil Steril 1992;57:456-8.