Expectant management of miscarriage - prediction of outcome using ultrasound and novel biochemical markers

被引:24
|
作者
Elson, J
Tailor, A
Salim, R
Hillaby, K
Dew, T
Jurkovic, D
机构
[1] Kings Coll Hosp London, Early Pregnancy & Gyneacol Assessment Unit, Dept Obstet & Gynaecol, London SE5 8RX, England
[2] Kings Coll Hosp London, Dept Biochem, London SE5 8RX, England
关键词
expectant management; IGFBP-1; inhibin A; inhibin pro alpha-C RI; miscarriage;
D O I
10.1093/humrep/dei038
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
BACKGROUND: The aim of this study was to examine the value of various ultrasound and biochemical parameters for the prediction of successful expectant management of miscarriage. METHODS: This was a prospective observational study. Clinically stable women with an ultrasound diagnosis of miscarriage were offered expectant management. In all cases, gestational age, size of retained products of conception, serum HCG, progesterone, 17-hydroxyprogesterone, insulin growth factor-binding protein 1 (IGFBP-1), inhibin A and inhibin pro alpha-C RI levels were recorded. Follow-up continued until resolution of the pregnancy. Clinical data, ultrasound findings and biochemical markers were analysed using univariate analysis and decision tree analysis. RESULTS: Fify-four women underwent expectant management of miscarriage. Thirty-seven (69%) had successful expectant management and 17 (31%) required surgery. The size of retained products, serum HCG, progesterone, inhibin A and inhibin pro alpha-C RI were all significantly different in those pregnancies that resolved spontaneously (P < 0.05). Serum inhibin A was the best predictor of a complete miscarriage. CONCLUSION: This study shows that novel biochemical markers may be used to predict the likelihood of successful expectant management of miscarriage.
引用
收藏
页码:2330 / 2333
页数:4
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