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The prognostic value of serum progesterone and quantitative beta-human chorionic gonadotropin in early human
C A Daily1, S L Laurent, W C Nunley
1Department of Obstetrics and Gynecology, Carolinas Medical Center, Charlotte.
Objective:
Our purpose was to determine whether serum progesterone, with or without quantitative beta-human chorionic gonadotropin, is predictive of pregnancy outcome within the first 8 weeks of gestation in asymptomatic women.
Study Design:
Asymptomatic patients at < 8 menstrual weeks' gestation were prospectively evaluated. The enrollment protocol included history, physical examination, ultrasonographic confirmation, and blood sample collection for beta-human chorionic gonadotropin and progesterone. The association between progesterone and beta-human chorionic gonadotropin values and pregnancy outcome was determined by logistic regression analysis. A receiver-operator characteristic curve was generated on the basis of the sensitivity and specificity of progesterone results.
Results:
Seventy-four patients were evaluated in this study. The mean serum progesterone level for viable pregnancies was 22.1 ng/ml, which was significantly greater than that for the nonviable gestations, 10.1 ng/ml (p < 0.001). A single progesterone level was predictive of pregnancy outcome (p < 0.001). The probability of an abnormal pregnancy outcome with a serum progesterone level < or = 6 ng/ml was 81%. A single beta-human chorionic gonadotropin level did not contribute to the prediction of pregnancy outcome (p = 0.59).
Conclusions:
Serum progesterone alone, within the first 8 weeks of gestation, is predictive of pregnancy outcome.