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Diagnostic Procedures in Threatened Abortion

Department of Obstetrics and Gynecology, Gentofte and Herlev Hospitals, University of Copenhagen, Denmark.

In a prospective study of 177 women admitted consecutively to the hospital because of vaginal bleeding in the first half of pregnancy, the predictive values of seven hormonal parameters and ultrasound examination were evaluated. Generally, the prediction of abortion proved to be more accurate than that of successful outcome. A single low value for human chorionic gonadotropin (hCG) or progesterone at admission, regardless of gestational age, or an ultrasound examination without signs of fetal life after the ninth week, was unavoidably followed by abortion. Normal hormone values or fetal life detected at ultrasound scan signified successful outcome correctly in 64 to 88% and 79%, respectively. However, in weeks six to nine, a single normal reading of hCG, pregnancy-specific ß₁-glycoprotein, or estriol, or ultrasound scan showing fetal life signs, was followed by successful outcome in every case. The combination of ultrasound scan without fetal life and a low estradiol or human placental lactogen value was inevitably followed by abortion from the sixth and ninth weeks onward, respectively. If paired values of hCG + estradiol or hCG + estriol were low, abortion followed in every case from the sixth and eighth weeks on, respectively.