Correlation of serum biomarkers with treatment result in women with first trimester threatened miscarriage
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Cách trích dẫn

Le, U. P., Ho, T. T. H., & Vo, V. D. (2023). Correlation of serum biomarkers with treatment result in women with first trimester threatened miscarriage. Tạp Chí Phụ sản, 21(1), 26-33. https://doi.org/10.46755/vjog.2023.1.1553

Tóm tắt

Objectives: To assess the correlation of serum biomarkers with treatment result in women with first trimester threatened miscarriage.

Materials and methods: Cross-sectional observative study in 107 patients which were first trimester threatened miscarriage at Department of Obstetrics and Gynecology, Hue Central Hospital and Hospital of Hue Medicine and Pharmacy University from March 2021 to June 2022. Inclusion criteria included women with threatened miscarriage and gestational age ≤ 13 weeks and 6 days. Participants were measured the levels of biomarkers (PAPP - A, CA 125, β-hCG, progesterone) and divided into two groups: group 1 included 90 women with successful treatment (continued pregnancy), and group 2 included 17 women with failed treatment (miscarriage, stillbirth).

Results: The level of maternal serum PAPP - A, β-hCG and progesterone for the successful treatment group were higher than the failed treatment group (p < 0.05). The median PAPP - A in group 1 and group 2 were 0.59 (0.12 - 2.04) IU/L and 0.02 (0.01-0.04) IU/L, respectively. The cut-off limit of 0.088 IU/L of PAPP - A level achieved sensitivity of 77.8% and specificity of 94.1%. The cut-off limit of 8004.5 mIU/ml of β-hCG level for ≤ 6 weeks gestational age group achieved sensitivity of 92% and specificity of 84.6%. The cut-off β-hCG value of 29162.5 mIU/ml for over 6 weeks to 13 weeks and 6 days group gave a sensitivity of 98.5% and specificity of 100%. The threshold progesterone value of 14.13 ng/dl gave a sensitivity of 93.3%, specificity of 94.1%. The median CA 125 in the group 2 was 74.01 (32.75 - 103.00) U/ml, that was higher than group 2 which was 40.90 (27.28 - 76.76) U/ml, p > 0.05. The cut-off CA 125 value of 68.55 U/ml for miscarriages gave a sensitivity of 58.8% and specificity of 71.1%.

Conclusions: Levels of maternal serum PAPP – A, CA 125, β-hCG and progesterone were early predictors of pregnancy outcome in women with first trimester threatened miscarriage.

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Tài liệu tham khảo

1. Nguyễn Vũ Quốc Huy, Cao Ngọc Thành, Lê Minh Tâm, Trương Quang Vinh. Thất bại thai kỳ. Huy, editor: Giáo trình Sản Phụ Khoa, Nhà xuất bản Đại học Huế; 2022.
2. Bulletins—Gynecology ACoOaGCoP. ACOG Practice Bulletin No. 200: Early Pregnancy Loss. Obstetrics and gynecology. 2018;132(5):e197-e207.
3. Tamara Callahan MD, Aaron Caughey MD. Early Pregnancy Complications. 6 th ed: Blueprints obstetrics & gynecology (6th ed). Baltimore, MD: Lippincott Williams & Wilkins; 2013.
4. Pillai RN, Konje JC, Tincello DG, Potdar N. Role of serum biomarkers in the prediction of outcome in women with threatened miscarriage: a systematic review and diagnostic accuracy meta-analysis. Human reproduction update. 2016;22(2):228-39.
5. Nguyễn Hữu Quyền. Nghiên cứu nồng độ beta hCG, progesterone và kết quả điều trị ở bệnh nhân dọa sẩy thai 3 tháng đầu. Quyền, editor: Luận văn Thạc sĩ của Bác sĩ nội trú. Trường Đại Học Y Dược Huế.; 2015.
6. Pradnya Digambar Kamble, Amarjeetkaur Bava, Mansi Shukla, Y. S. Nandanvar. First trimester bleeding and pregnancy outcome. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(4):1484-7.
7. Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Annals of epidemiology. 2010;20(7):524-31.
8. Nguyễn Bá Hoàng Anh. Nghiên cứu giá trị CA 125 trong dọa sẩy thai 3 tháng đầu. Anh, editor: Luận văn Thạc sĩ của Bác sĩ nội trú. Trường Đại Học Y Dược Huế; 2018.
9. Võ Thị Vy Lộc. Nghiên cứu đặc điểm lâm sàng, cận lâm sàng và kết quả điều trị dọa sẩy thai 3 tháng đầu thại Bệnh viện Phụ Sản-Nhi Đà Nẵng. Lộc, editor: Luận án chuyên khoa cấp II. Trường Đại học Y Dược Huế.; 2014.
10. Lê Thị Hương. Tình hình điều trị dọa sẩy thai ≤ 12 tuần tại Bệnh viện Phụ sản Thanh Hóa năm 2013. Hương, editor: Tạp Chí Phụ Sản. Tập 12 (02), 05 - 2014; 2013.
11. Kadam VK, Agrawal S, Saxena P. Predictive Value of Single Serum Progesterone Level for Viability in Threatened Miscarriage. 2019;69(5):431-5.
12. Al Mohamady M, Fattah GA, Elkattan E, Bayoumy R, Hamed DA. Correlation of Serum CA-125 and Progesterone Levels with Ultrasound Markers in The Prediction of Pregnancy Outcome in Threatened Miscarriage. International journal of fertility & sterility. 2016;9(4):506-11.
13. Haas DM, Hathaway TJ, Ramsey PS. Progestogen for preventing miscarriage in women with recurrent miscarriage of unclear etiology. The Cochrane database of systematic reviews. 2018;10(10):Cd003511.
14. Goetzl L, Krantz D, Simpson JL, Silver RK, Zachary JM, Pergament E, et al. Pregnancy-associated plasma protein A, free beta-hCG, nuchal translucency, and risk of pregnancy loss. Obstetrics and gynecology. 2004;104(1):30-6.
15. Duan L, Yan D, Zeng W, Yang X, Wei Q. Predictive power progesterone combined with beta human chorionic gonadotropin measurements in the outcome of threatened miscarriage. Archives of gynecology and obstetrics. 2011;283(3):431-5.
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