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Obstetrics & Gynecology 1981;57:207-214
© 1981 by The American College of Obstetricians and Gynecologists
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Human Chorionic Gonadotropin, Estradiol, Progesterone, Prolactin, and B-Scan Ultrasound Monitoring of Complications in Early Pregnancy

BASIL HO YUEN, MB, ChB, FRCS (C), JANET E. LIVINGSTON, MSc, BETTY J. POLAND, MB, BS, FRCOG, BERND K. WITTMANN, MD, FRCS (C), LYDIA SY, MSc and WENDY CANNON, BSc

From the Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada

Abstract

In a prospective study of women in the first trimester who were at risk for recurrent abortion, data from 20 pregnancies with normal outcomes were contrasted with those of 9 pregnancies that aborted spontaneously between 7 and 12 weeks. In pregnancies in which an embryo was present before abortion, the mean concentrations of human chorionic gonadotropin ß-subunit (hCG-ß) were low with a steady decline in progesterone levels, whereas estradiol (E2) and prolactin concentrations approximated those in normal pregnancies. With growth disorganization, mean hCG-ß, E2, and progesterone levels were significantly lower than normal. In 87.5% of embryopathic pregnancies, conclusive evidence of this disorder was obtained with ultrasound monitoring. Subnormal levels of hCG-ß, E2, and progesterone were observed in 88.9, 100, and 57.1%, respectively. The karyotype was abnormal in 80% of embryopathic pregnancies successfully cultured. The normal production of E2 appeared dependent on the presence of the embryo in the first trimester of pregnancy. Endocrine failure of the trophoblast and/or the corpus Iuteum in embryopathic pregnancy is suggested by diminished hCG-ß and progesterone concentrations. Serial ultrasound scanning and hormone assay, particularly of hCG-ß and E2, may be useful in assessing pregnancy at risk for recurrent abortion. However, because subnormal hormone levels may occur relatively late in the clinical course of embryopathic gestation, ultrasound scanning may yield more useful results as compared with hormone assay. Further studies are required to define more clearly the mechanisms of endocrine failure in embryopathic pregnancy.




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A. Henke, C. Marc Luetjens, M. Simoni, and J. Gromoll
Chorionic Gonadotropin {beta}-Subunit Gene Expression in the Marmoset Pituitary Is Controlled by Steroidogenic Factor 1, Early Growth Response Protein 1, and Pituitary Homeobox Factor 1
Endocrinology, December 1, 2007; 148(12): 6062 - 6072.
[Abstract] [Full Text] [PDF]




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Copyright © 1981 by the American College of Obstetricians and Gynecologists.