Hormone levels in threatened abortion

Expression of TGF-β1 and miR-99a in serum of patients with early spontaneous abortion and correlation with hormone levels during pregnancy

Expression of TGF-β1 and miR-99a in patients with early spontaneous abortion and correlation with hormone levels during pregnancy were investigated. A total of 70 pregnant women with early spontaneous abortion diagnosed in Jining No. 1 People's Hospital from February 1, 2015 to May 1, 2018 were selected as the study group, and 83 normal pregnant women who chose abortion for non-medical reasons in the same period as the control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect TGF-β1 and the levels of serum β-HCG, progesterone and estrogen during pregnancy in the two groups, and RT-qPCR to detect the expression of miR-99a, and partial correlation analysis to analyze the correlation of TGF-β1 and miR-99a with the levels of serum β-HCG, progesterone and estrogen in the study group of patients. Expression of β-HCG was significantly lower in the study group than that in the control group, with a statistically significant difference (P<0.001), and that of progesterone was significantly lower in the study group than that in the control group, with a statistically significant difference (P<0.001). Expression of estrogen was significantly lower in the study group than that in the control group, with a statistically significant difference (P<0.001). The partial correlation analysis indicated that the levels of serum β-HCG, progesterone and estrogen were positively correlated with TGF-β1 (r=0.944, 0.868, 0.869, P<0.001), negatively correlated with the expression level of miR-99a (r=−0.944, −0.892, −0.891, all P<0.001). miR-99a was highly expressed in the serum of patients with early spontaneous abortion, but TGF-β1 expression was low. The expression levels of the two factors are related to hormone levels during pregnancy, which are expected to be new candidate molecular diagnostic markers in the diagnosis of early spontaneous abortion.

Absorption of a first trimester fetus

A case of an 8-week fetus with ultrasound demonstrated heart beat, which was absorbed completely prior to abortion at 11 weeks' gestation, is reported.

Urinary estrone glucuronide, pregnanediol glucuronide and human chorionic gonadotrophin in threatened abortion

Estimations of urinary estrone glucuronide, pregnanediol glucuronide and human chorionic gonadotrophin were carried out by ELISA to see their potential in predicting an abnormal outcome in cases with vaginal bleeding in early pregnancy. Reference values were set up with samples from women without bleeding in present or past pregnancies and with normal ultrasonic findings. None of the parameters were found to be sensitive enough to predict an abnormal outcome. However, predictability of an abnormal value was found to be 95% for estrone-3-glucuronide (E1G), 93% for pregnanediol glucuronide (PdG) and 87% for human chorionic gonadotrophin (hCG).

Monitoring early production of chorionic gonadotrophin (HCG) following in vitro fertilization and embryo transfer

A rapid, sensitive assay was developed for monitoring HCG production and applied to serum and urine collection between days 4 and 20 after OPU in 55 patients treated by ovarian hyperstimulation and IVF. Eleven ongoing pregnancies, 2 ectopic pregnancies and 1 clinical abortion resulted. The earliest detection of a rise in HCG was on day 7 after OPU. The HCG values showed that trophoblastic tissue functioned transiently in another 11 patients and probably in another 5. Thus evidence for functioning trophoblastic tissue was obtained in a total of 30 patients (55%). These findings are important for the further improvement of IVF. No antibodies to administered HCG were detected.

Prognostic value of biochemical tests in the assessment of fetal outcome in threatened abortion

Maternal concentrations of serum progesterone, oestradiol, chorionic gonadotrophin, Schwangerschaftsprotein 1 and placental protein 5 were measured in 67 patients with threatened abortion. The levels of all biochemical variables were significantly reduced in those patients who had an unfavourable outcome. The clinical efficiency of each of these tests was very similar.

Log normal distribution of ovarian and placental steroid values in early human pregnancy

Concentrations of estradiol, progesterone, 17OH-progesterone were measured by radioimmunoassay in individual serum samples obtained from a group of 304 women with normal gestations between the 4th and 17th week of pregnancy. Values obtained underwent statistical analysis in order to determine the arithmetic mean and the 95% normal range (+/- two standard deviations). It was noted hereby that the spread of values above the mean was greater than that below the mean, and that very often the mean minus two standard deviations was either close to zero or negative. Therefore, the data for each hormone were analyzed for normality of the distributions by the chi-square test. For each hormone the chi-square test was significantly different (p less than 0.001) from the normal distribution (Gaussian). Subsequently, linear transformation by rankit analysis revealed the log-normal distribution of our data. Furthermore, rankit analysis was used as a graphical method to delineate a useful clinical range, which includes the mean and meaningful 95% confidence limits for estradiol, progesterone, and 17OH-progesterone in early normal pregnancies.

The prognostic value of serum human placental lactogen determinations in early pregnancy

Serial serum human placental lactogen (S-HPL) determinations were done in early pregnancy on 85 high-risk cases. Normal S-HPL values with a normal ultrasonogram had a 94.8 per cent successful outcome of pregnancy. Low S-HPL values were often accompanied by an abnormal or equivocal ultrasonogram (29.6 per cent). The fetal loss in patients with low S-HPL values and a normal ultrasonogram was 36.8 per cent.

Prognosis in threatened abortion: a comparison between predictions made by sonar urinary hormone assays and clinical judgement

One hundred patients admitted to hospital with a diagnosis of threatened abortion were assessed by means of sonar, urinary oestrogen, pregnanediol and human chorionic gonadotrophin (HCG) assays and clinical examination. Assay of oestrogen excretion was the most accurate (86-5 per cent) in predicting the ultimate outcome of pregnancy, but did not give as much information as sonar examination which gave an accurate prognosis in 84 per cent of cases and was much quicker to perform The reasons for the sonar failures are discussed. Assay of urinary pregnanediol excretion gave an accurate indication of outcome in 74 per cent of cases and 24-hour urinary HCG in 70 per cent although random urinary HCG estimations provided an accurate prediciton in only 54-5 per cent of cases. Clinical examination presented the usual difficulties in assessing uterine size and predicting abortion from the amount of bleeding and pain.

The diagnosis of early pregnancy failure by sonar

In a series of 425 consecutive patients examined by sonar in the first half of pregnancy 176 ultimately aborted. On analysis of the sonar and post-abortion findings it was found that the aborted pregnancies fell into five clearly defined groups; blighted ova or anembryonic pregnancies, missed abortions, hydatidiform moles and early and late live abortions. The blighted ova and the missed abortions comprised by far the largest and the early live abortions the smallest groups. Strict diagnostic sonar criteria of abnormality, independent of menstrual or clinical histories, were established for the first three of the groups, and an absolute diagnosis could be made at the time of the first examination in all cases of missed abortion and hydatidiform mole and in just over half of the cases of blighted ovum, the remainder requiring a second and occasionally a third examination. In the first half of the study the majority of the patients were allowed to abort spontaneously but with increasing confidence in the techniques patients were offered termination whenever the diagnosis of an abortive pregnancy was made. Anticipation of fetal death in utero or impending abortion of a live fetus proved to be a much more difficult problem, and in only those patients who aborted a live fetus before the tenth week of pregnancy did the sonar examination reveal any significant abnormality. Possible aetiological backgrounds to these groups of abortions are discussed in the light of the sonar findings.