title: Hormone pattern after misoprostol administration for a nonviable first-trimester gestation.
abstract: OBJECTIVE
  To evaluate serial hormone concentrations in subjects treated with vaginally administered misoprostol for early pregnancy failure.
  
  
  METHODS
  As part of a randomized clinical trial, serum was collected on treatment days 1, 3, 8, and 15.
  
  
  METHODS
  Multicenter clinical trial.
  
  
  METHODS
  Women with a nonviable first-trimester pregnancy.
  
  
  METHODS
  Serum concentrations of human chorionic gonadotropin (hCG), progesterone, and sex hormone binding globulin (SHBG) were evaluated.
  
  
  METHODS
  A logistic regression model was constructed to assess the associations of percent and complete expulsion of the gestational sac and/or successful management.
  
  
  RESULTS
  The percent change from the day of treatment until the first follow-up visit was predictive for complete expulsion for progesterone (P) (P<.005) and hCG (P<.005), but not for SHBG. The actual value was not significantly associated with complete expulsion or successful management. A decrease (day 1-3) of 79% for both hCG and P was associated with a 90% probability of complete passage of the gestational sac. A 90% probability of successful management was noted if P decreased by 78% on day 3 or 59% on day 7, or hCG decreased by 74% on day 3 or 78% on day 7 compared with pretreatment values.
  
  
  CONCLUSIONS
  Percent change, but not absolute change, in serial hormone values are strongly associated with both the complete expulsion of the gestational sac with one dose of misoprostol and ultimate success.
authors.affiliation: University of Pennsylvania Medical Center, Philadelphia, Pennsylvania 19104-5509, USA. kbarnhart@mail.obgyn.upenn.edu
authors.forename: Kurt T
authors.initials: KT
authors.lastname: Barnhart
authors.forename: Thomas
authors.initials: T
authors.lastname: Bader
authors.forename: Xiangke
authors.initials: X
authors.lastname: Huang
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Frederick
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Timbers
authors.forename: Jun Jim
authors.initials: JJ
authors.lastname: Zhang
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000022:Abortion, Spontaneous / Q000097:blood* / Q000188:drug therapy*; D000282:Administration, Intravaginal; D006063:Chorionic Gonadotropin / Q000097:blood*; D005260:Female; D006801:Humans; D016015:Logistic Models; D016595:Misoprostol / Q000494:pharmacology*; D009994:Osmolar Concentration; D011237:Predictive Value of Tests; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011374:Progesterone / Q000097:blood*; D019233:Retreatment; D012738:Sex Hormone-Binding Globulin / Q000032:analysis; D016896:Treatment Outcome
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D006063:Chorionic Gonadotropin; D012738:Sex Hormone-Binding Globulin; D016595:Misoprostol; D011374:Progesterone