Comparison of Serum Progesterone in Non-Viable Pregnancy and Ectopic Pregnancy
Abstract
Ectopic pregnancy (EP) and miscarriage are important differential diagnosis of first trimester vaginal bleeding. In first trimester, serum progesterone value can be 5-20 ng/ml in EP and miscarriage. Since delay in diagnosis of EP could have high mortality and morbidity, the aim of this study was comparison of serum progesterone value in EP and miscarriage in order to differentiate these conditions. A total of 60 patients (30 EP and 30 miscarriages) with gestational age of 5-7 weeks by LMP were enrolled in this study. The titer of progesterone and βhCG of serum were measured. The mean of progesterone and βhCG titers were compared in two groups by Student's t-test. The mean progesterone titer for all patients was 6.36±5.62 ng/ml, with a minimum value of 0.44 and maximum value of 21.50 ng/ml. Serum progesterone level in 33 patients was lower than 5 ng/ml and in 27 patients was between 5-25 ng/ml. Mean serum progesterone for miscarriage was 6.803±5.72 and for EP was 5.915±5.45 ng/ml. Difference between two values was not significant statistically (P=0.067). Mean βhCG for miscarriage was 1313.04 IU/l and for EP 1805.56 IU/l. Mean patients age were 27.2 totally that for miscarriage was 25.8 and for EP 28.5 years. This study indicated, the mean value of progesterone could not differentiate EP from miscarriage.
Cunningham FG, Leveno RJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams Obstetrics, 23th ed, New York: McGraw-Hill Medical 2011: 259-61.
Berek JS. Berek & Novak’s Gynecology, 14th ed. Philadelphia: Lippincott Williams & Wilkins 2012;450-60.
Speroff LM, Fritz A. Clinical Gynecology, Endocrinology, & Infertility, 17th ed. Philadelphia: Lippincott Williams & Wilkins 2005: 922-30.
Gibbs RS, Karlan BY, Haney AF, Nygaard I. Danforth’s Obstetrics & Gynecology. 10th ed. 2008, Philadelphia: Lippincott Williams & Wilkins 2008: 747-50.
Horne AW, van den Driesche S, King AE, Burgess S, Myers M, Ludlow H, Lourenco P, Ghazal P, Williams AR, Critchley HO, Duncan WC. Endometrial inhibin/activin beta-B subunit expression is related to decidualization and is reduced in tubal ectopic pregnancy. J Clin Endocrinol Metab 2008; 93(6): 2375-82.
El Bishry G, Ganta S. The role of single serum progesterone measurement in conjunction with beta hCG in the management of suspected ectopic pregnancy. JObstet Gynaecol 2008; 28(4):413-7.
Katsikis I, Rousso D, Farmakiotis D, Kourtis A, Diamanti- Kandarakis E, Panidis D. Receiver operator characteristics and diagnostic value of progesterone and CA-125 in the prediction of ectopic and abortive intrauterine gestations. Eur J Obstet Gynecol Reprod Biol 2006; 125(2):226-32.
Perkins SL, Al-Ramahi M, Claman P. Comparison of serum progesterone as an indicator of pregnancy nonviability in spontaneously pregnant emergency room and infertility clinic patient populations. Fertil Steril 2000; 73(3):499-504.
Valley VT, Mateer JR, Aiman EJ, Thoma ME, Phelan MB. Serum progesterone and endovaginal sonography by emergency physicians in the evaluation of ectopic pregnancy. Acad Emerg Med 1998; 5(4):309-13.
al-Sebai 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 Gynaecol 1995;102(5):364-9.
McCord ML, Muram D, Buster JE, Arheart KL, Stovall TG, Carson SA. Single serum progesterone as a screen for ectopic pregnancy: exchanging specificity and sensitivity to obtain optimal test performance. Fertil Steril 1996; 66(4):513-6.
Ugurlu EN, Ozaksit G, Karaer A, Zulfikaroglu E, Atalay
A, Ugur M. The value of vascular endothelial growth factor, pregnancy-associated plasma protein-A, and progesterone for early differentiation of ectopicpregnancies, normal intrauterine pregnancies, and spontaneous miscarriages. Fertil Steril 2009; 91(5):1657-61.
Florio P, Severi FM, Bocchi C, Luisi S, Mazzini M, Danero S, Torricelli M, Petraglia F. Single serum activin a testing to predict ectopic pregnancy. J Clin Endocrinol Metab. 2007; 95(5): 1748-53
Florio P, Gabbanini M, Borges LE, Bonaccorsi L, Pinzauti S, Reis FM, Boy Torres P, Rago G, Litta P, Petraglia F. Activins and related proteins in the establishment of pregnancy. Reprod Sci. 2010;17(4):320-30.
Files | ||
Issue | Vol 51, No 10 (2013) | |
Section | Articles | |
Keywords | ||
Ectopic pregnancy Miscarriage Progesterone |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |