Rapid measurement of urinary pregnanediol glucuronide to diagnose ectopic pregnancy.
We investigated the ability of a single, random, urinary pregnanediol-3 alpha-glucuronide level to differentiate early intrauterine from ectopic pregnancy. Thirty-four patients with intrauterine gestations were compared with 60 patients with ectopic pregnancies. Urinary pregnanediol-3 alpha-glucuronide was measured by radioimmunoassay and enzyme immunoassay. Compared with intrauterine gestations, results demonstrate that urinary pregnanediol-3 alpha-glucuronide is significantly depressed in ectopic pregnancies: 24.5 +/- 2.2 versus 4.8 +/- 0.7 micrograms/ml (p = 0.0001). Urinary pregnanediol-3 alpha-glucuronide levels obtained by conventional radioimmunoassay correlated closely with values measured in minutes with enzyme immunoassay (r = 0.95, p = 0.0001), and with serum progesterone (r = 0.74, p = 0.0001). Urinary pregnanediol-3 alpha-glucuronide measured by enzyme immunoassay exhibited predictive values for detecting ectopic gestations comparable with random serum progesterone or serum beta-human chorionic gonadotropin values. We conclude that ectopic gestations demonstrate a reduced level of urinary pregnanediol-3 alpha-glucuronide (55/60 cases) detectable with a rapid enzyme immunoassay, which makes this assay a practical screening test in early pregnancy.
Sauer
M V
MV
Division of Reproductive Endocrinology, University of Southern California, Los Angeles.
Vermesh
M
M
Anderson
R E
RE
Vijod
A G
AG
Stanczyk
F Z
FZ
Lobo
R A
RA
D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000175:diagnosis*; D011276:Pregnanediol / Q000031:analogs & derivatives* / Q000652:urine; D011374:Progesterone / Q000097:blood; D011863:Radioimmunoassay; D012680:Sensitivity and Specificity; D013997:Time Factors
D006063:Chorionic Gonadotropin; C022270:pregnanediol-3 alpha-glucuronide; D011374:Progesterone; D011276:Pregnanediol