title: Comparison of serum progesterone as an indicator of pregnancy nonviability in spontaneously pregnant emergency room and infertility clinic patient populations.
abstract: OBJECTIVE
  To compare the predictive value of serum progesterone in identifying nonviable pregnancy in symptomatic spontaneously pregnant emergency department patients and asymptomatic patients attending an infertility clinic.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  Tertiary-care academic health center.
  
  
  METHODS
  One hundred thirty-seven pregnant patients who presented to the emergency department for whom clinical outcomes were available, and 123 consecutive patients who became pregnant during treatment at the infertility clinic.
  
  
  METHODS
  Serum progesterone measurement.
  
  
  METHODS
  The sensitivity, specificity, and predictive value of serum progesterone <45 nmol/L in identifying nonviable pregnancies were determined for each of the groups.
  
  
  RESULTS
  Sensitivity and specificity of serum progesterone <45 nmol/L in predicting nonviable pregnancies were 88.6% and 87.5%, respectively, in spontaneously pregnant patients who presented to the emergency department with pain or bleeding and 58.8% and 100% in infertility patients who had undergone controlled ovarian hyperstimulation for in vitro fertilization or intrauterine insemination. Sensitivity and specificity for all other infertility clinic patients were variable.
  
  
  CONCLUSIONS
  The predictive value of low serum progesterone in identifying nonviable pregnancies varies with patient populations.
authors.affiliation: University of Ottawa and Ottawa Hospital-Civic Campus, Ottawa, Ontario, Canada. slperkins@civich.ottawa.on.ca
authors.forename: S L
authors.initials: SL
authors.lastname: Perkins
authors.forename: M
authors.initials: M
authors.lastname: Al-Ramahi
authors.forename: P
authors.initials: P
authors.lastname: Claman
mesh_terms: D000022:Abortion, Spontaneous / Q000453:epidemiology; D000465:Algorithms; D005189:False Positive Reactions; D005260:Female; D005313:Fetal Death / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D010062:Ovulation Induction; D011237:Predictive Value of Tests; D011247:Pregnancy; D011271:Pregnancy, Ectopic / Q000453:epidemiology; D011374:Progesterone / Q000097:blood*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D011374:Progesterone