[How to predict spontaneous resolution of early pregnancies?]

Assessment of early pregnancy is indicated in women with suspected abnormalities. It is based on biochemical assessment and on trans vaginal sonography. To identify clinical, biological and ultrasonographic parameters that are predictive of spontaneous pregnancy resolution. A prospective observational study was performed interesting women with a positive pregnancy test without visualization of the pregnancy on the initial scan. All parameters measured during the initial visit were tested by univariate and multivariate analysis to identify parameters predicting spontaneous resolution of pregnancy. A total of 2675 women were included in the study. In 94 cases [4%] the location of pregnancy was unknown. Univariate and multivariate analysis showed that four parameters contributed significantly to the predictive power of the logistic model: Absence of pain [p =0,036], endometrial thickness < … 12 mm [p =0,021], initial serum beta hCG level < 1000 UI/l [p =0,015] and progesterone level < 29 nmol/l [p <0,001]. Women with a high probability of spontaneous resolution of their pregnancies can benefit from a spaced monitoring until the rate of beta -hCG will be negative

Prediction of ectopic pregnancy in early pregnancy of unknown location

Women having pregnancies of unknown location [PUL] can be defined as those having positive pregnancy test when no pregnancy is visualized on transvaginal ultrasound [TVS]. To identify diagnostic parameters which are predictive of ectopic pregnancies in women with early pregnancies of unknown location. We undertook a prospective observational study of pregnant women with suspected early pregnancy complications. Ninety-four patients were classified as having a pregnancy of unknown location [PUL] by transvaginal ultrasound; blood sample was taken on presentation to measure the serum human chorionic gonadotrophin [,-HCG] and progesterone levels. All collected data were tested by univariate analysis and then analyzed in a stepwise procedure to form a logistic model for predicting ectopic pregnancy. A total of 2675 women were referred for suspected early pregnancy was unknown. Three parameters were found to be statistically significant for predicting ectopic pregnancy: progesterone level, vaginal bleeding associated with pain and the presence of free fluid in the pouch of Douglas. The overall model described by these variables offer a sensitivity of 79 %and a specificity of 59% in the prediction of ectopic pregnancy. Logistic regression model can help in the clinical decision-making in women with pregnancy of unknown location