The Prognostic Value of Single Serum Progesterone in Early Pregnancy

Lee, M H; Lee, H H; Lee, S M; Kang, J M; Lee, J J; Nam, K H; Lee, K H

Abstract

OBJECTIVES
To assess the prognostic value of a single maternal serum progesterone measurement in the immediate diagnosis of early pregnancy and in the long term prognosis of pregnancy outcome.
METHODS
Women with early pregnancies of 4~7 weeks who visit to the hospital for a pregnancy test were included to this study. Measurement of serum progesterone was peformed prospectively. The comparative study groups were divided into two groups according to their final diagnosis retrospectively at each gestational age. Seventy patients were evaluated in this study. Normal intrauterine pregnancy group consisted of 34 patients with continuing pregnant with fetal heart activity by ultrasonography, abnormal intrauterine pregnancy group consisted of 36 patients with missed abortion, incomplete abortion and anembryonic pregnancy.
RESULTS
Progesterone levels were significantly lower in the abnormal intrauterine pregnancy (5.6+/-3.8 ng/mL, 11.5+/-5.8 ng/mL) than in the normal intrauterine pregnancy group (21.0+/-6.5 ng/mL, 20.3+/-6.6 ng/mL) at 4~5 weeks of gestation (p<0.001, p<0.05), but were not significantly differentiated between two groups at 6~7 weeks of gestation. The level of progesterone below 15 ng/mL conceived by receiver-operator characteristic curve was found to be detecting a abnormal pregnancy from comparative groups at 4~5 weeks (specificity 88.9%, 77.0%, sensitivity 100%, 88.9%).
CONCLUSIONS
A single serum progesterone measurement taken in 4~5 weeks of gestation is valuable in the immediate diagnosis of early pregnancy and in the long term prognosis of pregnancy outcome. The best progesterone cut off point that predicts abnormal early pregnancy is 14 ng/mL.