Single Progesterone Test Can Rule Out Viable Pregnancy
(HealthDay News) – For women in early pregnancy with symptoms and an inconclusive ultrasound assessment, a single progesterone measurement can rule out a viable pregnancy, according to a study published online Sept 27 in BMJ.
Jorine Verhaegen, from the Academic Medical Centre at the University of Amsterdam, and colleagues reviewed the literature to examine the accuracy with which a single progesterone measurement in early pregnancy can distinguish between viable and non-viable pregnancy. Twenty-six cohort studies involving 9,436 pregnant women were reviewed, comprising seven studies in women with symptoms and inconclusive ultrasound assessment and 19 studies in women with symptoms alone.
For women with symptoms and inconclusive ultrasound assessment, the researchers found that the progesterone test predicted non-viable pregnancy with pooled sensitivity of 74.6%; specificity of 98.4%; and positive and negative likelihood ratio of 45 and 0.26, respectively. Non-viable pregnancy had a median prevalence of 73.2%, and if the progesterone was low, the probability increased to 99.2%. For women with symptoms alone, when a threshold of 10ng/mL was used, the progesterone test had a higher specificity and predicted a non-viable pregnancy with pooled sensitivity of 66.5%; specificity of 96.3%; and positive and negative likelihood ratio of 18 and 0.35, respectively. If progesterone was low, the probability of a non-viable pregnancy increased from 62.9–96.8%.
"Our review suggests that a single serum progesterone measurement is more accurate when it follows an inconclusive ultrasound assessment; in women with pain or bleeding who did not have an ultrasound scan, the progesterone test was less accurate in predicting viability of a pregnancy," the authors write.