Uterine artery Doppler and urinary hyperglycosylated HCG as predictors of threatened abortion outcome

Abstract

Objective: To study the role of uterine artery Doppler and urinary hyperglycosylated hCG (hCG-H) in predicting threatened abortion outcome. Methods: A prospective observational study was conducted on 93 cases with threatened abortion (study group) and 50 cases with normal pregnancy (control group) at 6–12 weeks of gestation. Uterine artery Doppler examination was performed and urinary hCG-H was measured in all cases. Cases were followed up till delivery and the number of aborted cases was recorded. Results: Urinary hCG-H concentration was significantly higher in the control group and in cases who continued than in cases who miscarried 5.3 ± 3.9 vs. 2.1 ± 3.0 mIU/ml equivalents (P = 0.002) for the first and 5.1 ± 4.5 vs. 2.1 ± 3.0 mIU/mlEq (P = 0.003) for the second respectively. The ratio of hyperglycosylated hCG to total hCG was >51% in the 116 term outcome cases while it was below 49% in the 29 cases who miscarried. Unilaterally increased uterine artery pulsatility index and Δ uterine artery pulsatility index values were significantly higher in women who miscarried than in those with continuing pregnancies or the control groups (P < .0001). ROC for uterine artery Doppler revealed an area under the curve AUC of 0.77, while for urinary HCG-H the AUC was 0.82 and for uterine artery Doppler and urinary HCG-H combined the AUC reached 0.93. Conclusion: The unilaterally increased uterine arteries pulsatility index and the decreased urinary hCG-H production in the first trimester could predict miscarriage in threatened abortion.

Keywords

• Threatened abortion
• Uterine artery Doppler
• Hyperglycosylated HCG
• Pregnancy outcome