Prediction of Pregnancy Outcomes in Women with Threatened Abortion Using Ultrasound Parameters, Uterine Artery Doppler, and Serum Progesterone Levels: A Prospective Cohort Study

Abstract

Purpose: The study investigated the transvaginal ultrasound parameters, uterine artery doppler and serum progesterone level to predict pregnancy outcome in women experiencing threatened abortion in our population.

Methods: Prospective cohort study. TVS was performed to determine gestational age, viability and parameters like gestational sac, CRL, subchorionic hematoma (SCH), FHR. UA doppler PI was calculated. Serum progesterone level was estimated on the day of presentation. Each patient was managed as per the hospital protocol with conservative management and progesterone supports and followed up till 20 weeks of pregnancy.

Results: Among 120 women, forty-four (36.66%) women had abortion in spite of adequate conservative management with progesterone support and seventy-six women (63.33%), continued the pregnancy. Age of participants, parity index, BMI in both the groups were comparable. Those with irregular gestational sac, bradycardia, presence of SCH at the initial presentation had failing pregnancy. Among women who continued the pregnancy serum Progesterone level was 25.70 ± 18.13 ng/ml as compared to 13.21 ± 11.32 ng/ml among those who aborted (p-value < 0.001). However, UA doppler did not find any significance among the two groups.

Conclusion: The mean serum progesterone was higher in women who continued pregnancy than those who aborted among those who presented with threatened abortion. A good TVS to identify the ultrasound parameters like regularity of gestational sac, yolk sac, FHR, CRL, SCH helps to predict obstetric outcome in threatened abortion. However uterine artery doppler did not play a significant role in the prediction of the outcome.

Keywords: Prediction; Prospective cohort study; Serum progesterone; Threatened abortion; Uterine artery doppler.