Comparison of serum progesterone as an indicator of pregnancy nonviability in spontaneously pregnant emergency room and infertility clinic patient populations.
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.
Perkins
S L
SL
University of Ottawa and Ottawa Hospital-Civic Campus, Ottawa, Ontario, Canada. slperkins@civich.ottawa.on.ca
Al-Ramahi
M
M
Claman
P
P
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
D011374:Progesterone