Serial hCG and progesterone levels to predict early pregnancy outcomes in pregnancies of uncertain viability: A prospective study

Abstract : Objective To assess the value of serial hCG and progesterone serum level in the diagnosis of early pregnancy viability. Methods It was a prospective cohort study. Women with a pregnancy of uncertain viability (PUV), defined as the presence of an intra-uterine embryo with a crown-rump length <7 mm with no cardiac activity or an intra-uterine gestational sac size <25 mm with no visible embryonic structure in a transvaginal ultrasound scan (TVS) were eligible. The diagnosis value of serial plasmatic hCG levels on the first day and 48 h after as well as the initial progesterone level were evaluated to diagnose pregnancy viability. Pregnancy viability was assessed by TVS 7 to 14 days after inclusion. Results The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of an hCG H48/H0 ratio increase <11% to diagnose an early pregnancy loss were 70.6%, 100%, 100% and 85.3%, respectively. The sensitivity, specificity, PPV and NPV of a 6.2 ng/ml progesterone level to diagnose an early pregnancy loss were 20%, 100%, 100% and 65.2%, respectively. The sensitivity, specificity, PPV and NPV of an hCG H48/H0 ratio increase >75% to diagnose a viable pregnancy were 100%, 31%, 45.9% and 100%, respectively. hCG H48/H0 ratio increase <11% was associated with early pregnancy loss in 100% of the cases. hCG H48/H0 ratio increase >75% was associated with 100% of viable pregnancies in 100% of the cases. Conclusion Serial hCG levels alone permitted an early viability diagnosis within 48 h for 41.1% of patients with PUV instead of 7 to 14 days with TVS. © 2017
Type de document :
Article dans une revue
European Journal of Obstetrics & Gynecology and Reproductive Biology, 2018, 220, pp.100-105. 〈10.1016/j.ejogrb.2017.11.020〉
Liste complète des métadonnées

https://hal-univ-rennes1.archives-ouvertes.fr/hal-01671466
Contributeur : Laurent Jonchère <>
Soumis le : vendredi 22 décembre 2017 - 11:54:26
Dernière modification le : lundi 26 mars 2018 - 14:46:33

Identifiants

Collections

Citation

C. Puget, Y. Joueidi, E. Bauville, B. Laviolle, C. Bendavid, et al.. Serial hCG and progesterone levels to predict early pregnancy outcomes in pregnancies of uncertain viability: A prospective study. European Journal of Obstetrics & Gynecology and Reproductive Biology, 2018, 220, pp.100-105. 〈10.1016/j.ejogrb.2017.11.020〉. 〈hal-01671466〉

Partager

Métriques

Consultations de la notice

34