Role of biochemical parameters in the differential diagnosis of viable pregnancy, anembryonic pregnancy and intrauterine fetal exitus in cases of first trimester threatened abortion: Birinci trimester düşük tehdidi olan hastalarda anembriyonik gebelik, intrauterin eksitus ve sağlıklı gebeliğin ayırıcı tanısında biyokimyasal parametrelerin yeri

Ozan  Özolcay; Bulat Aytek Şık

doi:10.14687/jhs.v18i3.6019

Authors

Ozan Özolcay Taksim Eğitim ve Araştırma Hastanesi https://orcid.org/0000-0002-9416-6153
Bulat Aytek Şık Sisli Kolan International Hospital https://orcid.org/0000-0002-4165-9405

DOI:

https://doi.org/10.14687/jhs.v18i3.6019

Keywords:

First trimester, Abortus imminens, Transvaginal ultrasonography, Estradiol, Progesterone, β-hCG, Birinci trimester, Transvajinal ultrasonografi

Abstract

It is aimed to establish criteria about the prognosis and life potential of pregnancy by using ultrasonographic imaging techniques and hormonal parameters to evaluate embryonic life potantial in threatened miscarriage patients. Our study consists of 45 pregnant patients who were admitted for vaginal bleeding during pregnancy and were diagnosed as a threatened miscarriage. The study group consisted of pregnant women diagnosed with threat of miscarriage pregnancy week is lower than 20 weeks according to their last menstrual period. Estradiol, Progestrone, β-hCG hormone level are measured from patients, the same day after the ultrasound examination. The group whose pregnancy resulted with live birth and the group whose pregnancy ended with spontaneous abortion were statistically compared according to their hormonal parameters; it was found to be significantly lower in the group that resulted in live birth (p <0.01). Sensitivity, specificity, negative and positive predictive values of β-hCG, E2, P4 levels were found to be significant in patients with threatened miscarriage. Increase both time loss and correct diagnosis rate, after vaginal speculum examination the first choice in patients with abortus imminens is to request a transvaginal ultrasonographic examination and then assesment of hormonal parameters (β-hCG, progesterone, estradiol) if necessary.

Extended English summary is in the end of Full Text PDF (TURKISH) file.

Özet

Düşük tehdidi olan hastalarda embriyonik yaşamın devamını değerlendirmek için ultrasonografik görüntüleme teknikleri ve hormonal belirteçleri kullanarak gebeliğin prognozu ve yaşam potansiyeli hakkında kriterler oluşturmak amaçlanmıştır. Çalışmamız, gebelikte vajinal kanama nedeniyle başvuran ve düşük tehdidi tanısı alan 45 gebe hastadan oluşmaktadır. Herhangi bir sistemik hastalığı bulunmayan ek bir jinekolojik patolojisi olmayan ve son adet tarihinden kesin olarak emin olan hastalar çalışma gruplarına dahil edildi. Çalışma grubu son adet tarihine göre 20 hafta ve daha küçük gestasyonel haftadaki düşük tehdidi tanısı alan gebelerden oluştu. Hastalardan Estradiol, Progestrone, β-hCG ölçümleri yapıldı. Gebeliği canlı doğum ile sonuçlanan grup ile gebeliği spontan abortusla sonlanan grubun β-hCG, P₄, E₂ degerleri istatiksel olarak karşılaştırıldığında; canlı doğum ile sonuçlanan grupta anlamlı olarak düşük bulunmuştur (p<0.01). Abortus imminensli hastalarda β-hCG, E_2,P₄ düzeylerinin sensivite spesifite, negatif ve pozitif prediktif değerleri anlamlı çıkmıştır. Abortus imminensli hastalarda vaginal muayene sonrası yapılacak ilk iş hem vakit kaybını hem de doğru tanı oranını arttırmak için ilk olarak transvajinal ultrasonografik inceleme ve ardından gerekirse hormonal parametreleri (β -hCG, progesteron, estradiol) istemek doğru olacaktır.

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Author Biographies

Ozan Özolcay, Taksim Eğitim ve Araştırma Hastanesi

Op. Dr., Kadın Hastalıkları ve Doğum Bölümü, Taksim Eğitim ve Araştırma Hastanesi

Bulat Aytek Şık, Sisli Kolan International Hospital

Op. Dr. Kadın Hastalıkları Doğum ve Tüp Bebek Bölümü, Şişli Kolan İnternational Hospital

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