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THE ROLE OF PROGESTERONE IN DETECTING EARLY PREGNANCY FAILURE

Hanita, O; Hanisah, A H

Pathology - Journal of the RCPA: 2009 - Volume 41 - Issue - p 69–70
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Department of Pathology, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia

Background: Early pregnancy failure is a common pregnancy complication. In clinical practice, the time delay to distinguish viable from non‐viable pregnancy is often distressing to patients and doctors. A highly sensitive and specific biomarker that accurately identifies viable and non‐viable pregnancy would be useful for early intervention. Progesterone has been shown as a biomarker of early pregnancy failure, however the usefulness is still questionable due to different cut‐off values used.

Aims: To determine the role of progestesterone as a marker of early pregnancy failure and to establish the cut‐off value in discriminating viable from non‐viable pregnancy.

Method: A cross sectional study was carried out in the Obstertric and Gynaecology Patient Admission Centre (OBPAC) for a period of 12 months. Ninety‐five pregnant women of 13 weeks or less period of amenorrhoea (POA), of which 14 normal pregnant women as control, were recruited. A single measurement of serum progesterone was carried out during admission. The outcome of pregnancy was followed up until 22 weeks of POA to ascertain viability.

Results: Progesterone levels were significantly lower in women with non‐viable pregnancies as compared with viable pregnancy [10.7 ng/mL (0.60–49.80) versus 45.9 ng/mL (15.40–127.20), respectively; p<0.001]. Progesterone levels were also significantly lower in threatened abortion patients with outcome of non‐viable pregnancy compared to those pregnancies that progressed on to the viability period [23.3±12.0 versus 89.7±33.2, respectively; p<0.001]. At cut‐off value of 32.7 ng/mL, progesterone had 90% sensitivity with 75% negative predictive value and 92% specificity with 97% positive predictive value. The area under curve for progesterone was 0.95 (95% confidence interval 0.903–0.990).

Conclusion: Progesterone can be used as a marker for early pregnancy failure.

© 2009 Royal College of Pathologists of Australasia