VALIDITY OF SERUM PROGESTERONE LEVEL OF <20ng/ml AS A PREDICTOR OF SPONTANEOUS MISCARRIAGE
Objective: To validate the serum progesterone levels <20ng/ml as a predictor of spontaneous miscarriage amongst women with threatened miscarriage during the first trimester of pregnancy.
Study Design: Cross Sectional Validation study.
Setting and duration: Outpatient department of obstetrics and gynaecology Military hospital, Rawalpindi from February-July, 2016 over a period of six months.
Methodology: All the women with singleton pregnancy presenting with threatened miscarriage during the first trimester were recruited in the study and followed for 4 weeks on weekly basis to determine whether the pregnancy is ongoing or ended up in spontaneous miscarriage (fetal demise). Descriptive statistics were used for quantitative variables and frequencies for qualitative variables. Independent sample t-test was applied to compare mean values of serum HCG and progesterone, and validity of serum progesterone was calculated at a cut off the level of <20ng/ml.
Results: Out of 93 pregnant women who participated in the study, 25 (26.8%) had a miscarriage till 4th week of follow up. Serum progesterone levels showed a significant difference between ongoing pregnancy group and miscarriage group (P-value<0.001). When the cut off value of serum progesterone was taken as < 20 ng/ml, the Sensitivity, Specificity, PPV and NPV was found to be 92.00%, 95.59%, 88.46% and 97.01% respectively.
Conclusion: The cut off the value of serum progesterone at <20ng/ml is a useful screening tool for the identification of pregnancy outcomes in women presenting with threatened miscarriage.
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