Document Detail


A multiple marker model to predict pregnancy viability when progesterone is indeterminate.
MedLine Citation:
PMID:  18472646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To develop a model to differentiate viable from nonviable pregnancies at a single first-trimester visit. STUDY DESIGN: This prospective cohort study included 256 symptomatic women in the first trimester who presented to our urgent care unit in Providence, Rhode Island, between 2002 and 2004. Predictors of pregnancy viability were collected, including clinical information and serum samples for several biomarkers. Each predictor was evaluated alone and in conjunction with other variables using receiver operator characteristic curves. The cohort was separated into 2 subgroups based on whether the progesterone value was at the "extremes" (<5 ng/mL or >25 ng/mL) or in the "grey zone" (5-25 ng/mL). RESULTS: Among single biomarkers, progesterone had the greatest diagnostic accuracy in predicting viability. Progesterone was highly accurate at the extremes (area under the curve [AUC] = 0.99) but less accurate in the grey zone (AUC = 0.71). A multiple marker model was developed to include progesterone for all patients, and human chorionic gonadotropin, ultrasound findings and symptoms for participants in the grey zone (AUC = 0.90). CONCLUSION: A multiple marker model predicted pregnancy viability in symptomatic women with overall accuracy of 90%.
Authors:
Beth J Plante; Jeffrey D Blume; Geralyn Lambert-Messerlian; Rebecca Shackelton; Jacob Canick; Maureen G Phipps
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  53     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-05-13     Completed Date:  2008-09-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  243-9     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Women and Infants Hospital, Brown Medical School, USA. bethplante@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Biological Markers / blood
Chorionic Gonadotropin / blood
Female
Fetal Viability*
Humans
Inhibins / blood
Models, Statistical*
Pregnancy
Pregnancy Trimester, First
Progesterone / blood*
Prospective Studies
ROC Curve
Sensitivity and Specificity
Ultrasonography, Prenatal
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Chorionic Gonadotropin; 0/inhibin A; 57-83-0/Progesterone; 57285-09-3/Inhibins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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