Publication:

Single serum progesterone measurement: a key diagnostic and prognostic tool in threatened abortion

Background Miscarriage represents a prevalent complication during pregnancy, often leaving both patients and healthcare providers grappling with the anxiety of distinguishing viable from nonviable pregnancies in a timely manner. Identifying a highly sensitive and specific biomarker for this purpose could greatly enhance early intervention strategies. Progesterone has emerged as a significant biomarker for early pregnancy failure. This study aims to assess the effectiveness of a single serum progesterone measurement in cases of threatened abortion and its correlation with pregnancy outcomes.

Methods Conducted at the Gynaecology and Obstetrics Department of Sir Salimullah Medical College and Mitford Hospital in Dhaka between January and June 2020, this cross-sectional study included 60 women. Group I consisted of 30 patients (6 to 12 weeks of gestation) with vaginal bleeding, while Group II comprised 30 women with normal viable pregnancies of the same gestational age.

Results The mean age was approximately 24.87±3.79 years in Group I compared to 23.7±4.19 years in Group II. Notably, the mean serum progesterone levels were significantly different, with Group I showing 51.02±30.77 ng/ml versus 80.39±20.68 ng/ml in Group II (p<0.05). At 22 weeks of pregnancy, 60.0% of patients in Group I and 100.0% in Group II had viable outcomes, which was statistically significant (p<0.05). A serum progesterone cut-off value of ≥61 ng/ml demonstrated an 86.7% sensitivity and 70.0% specificity for predicting threatened abortion.

Conclusions Serum progesterone levels significantly differentiate between cases of threatened abortion and normal pregnancies, establishing it as a reliable marker for early pregnancy failure.