CC BY 4.0 · Rev Bras Ginecol Obstet 2019; 41(09): 525-530
DOI: 10.1055/s-0039-1696948
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Progesterone's Serum Level and a New Ultrasonographic Parameter in the First Trimester Pregnancy – Prognostic Factors for Embryonic Demise

1  Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania.
,
Razvan Ciortea
1  Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania.
,
Andrei Mihai Malutan
1  Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania.
,
Costin Berceanu
2  Department of Obstetrics and Gynecology, University of Medicine and Pharmacy of Craiova, Craiova, Romania
,
Maria Patricia Rada
1  Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania.
,
Dan Mihu
1  Department of Obstetrics and Gynecology, University of Medicine and Pharmacy “Iuliu Haţieganu”, Cluj-Napoca, Romania.
› Author Affiliations
Further Information

Publication History

20 November 2018

15 July 2019

Publication Date:
23 September 2019 (online)

  

Abstract

Objective The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (40%). The purpose of the present study is to evaluate the correlation between a serum biomarker, progesterone, and an ultrasonographic parameter, the distance between yolk sac and embryo (DYSE) in assessing the prognosis of pregnancy outcome in the 1st trimester.

Methods The present study is a prospective case-control analysis that includes 2 groups of patients: 81 patients with first-trimester normal evolutive pregnancy and 89 patients with embryonic demise, all of the patients having between 6 and 11 weeks of amenorrhea. Endovaginal ultrasonographic exploration was performed to evaluate the distance between the lower pole of the embryo and the yolk sac. From each subject enrolled in the study, 20 ml of blood was collected for progesterone serum level measurement.

Results Regarding the DYSE in the case group, lower values were observed compared with the control group, the difference being statistically significant. In the statistical analysis of serum progesterone values, statistically significant differences were observed between the 2 groups (p < 0.05).

Conclusion The DYSE has a high positive predictive value in identifying pregnancies with potentially reserved outcome, with the present study demonstrating that a DYSE < 3 mm causes an unfavorable evolution of the pregnancy. Low serum levels of progesterone are associated with an increased rate of nonviable embryos. The correlation between these two parameters increases the effectiveness of screening methods in prenatal monitoring and improves the diagnostic methods for the first-trimester pregnancies whose outcome potential can be reserved.

Contributors

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.