ABSTRACT
Threatened abortion is the commonest complication in pregnancy, it is defined as vaginal bleeding with or without menstrual like cramps in the first 20 weeks of pregnancy. No history of passage of tissue or rupture of membrane is present and ultrasound demonstrates an intrauterine sac with fetal cardiac activity. The early and accurate prediction of unsuccessful pregnancy in this situation should lead to appropriate treatment without unnecessary delay, but still there is no efhctive marker to predict in advance the outcome of threatened abortion. Inhibin A concentration rises and falls during the menstrual cycle. The lowest level is during the early and late days of the cycle and peaks during midcyles coincident with LH surge and midlureal period [being twofold higher than the first]. its level is higher in pregnant women than in non pregnant, and increases throughout pregnancy until delivery. in the early weeks of gestation, the corpus luteum is the principal source of inhibin but about the eighth week, it is excreted from the fetoplacental unit, immediately after delivery it's level decreases sharply. Th aim of the present research was to study the possible role of inhibin A in predicting pregnancy outcome in women with threatened abortion. This study included fifty pregnant women at 8 and 10 weeks gestational age, they were divided into: Groujy I [studied group] including 30 pregnant women with threatened abortion. Group II [control group] including 20 healthy not complaining pregnant women matched with the studied group. All of them were subjected to the following: Complete history taking, general clinical examination; obstetric examination; routine laboratory investigations; ultrasound examination for detection of fetal viability and fetal parameters; maternal blood samples were collected for determination of the quantitative measurement of inhibin A and follow up of cases till reaching 20 weeks of gestational age. The studied groups were further subdivided according to the outcome of pregnancy into: Group A [threatened abortion and fluting pregnancies] n 15; group B [threatened abortion bui ongoing pregnancies] n 15. The results of the study were analysed statistically, and we found that; there was a significant decrease in the levels of inhibin A in cases of threatened abortion [group I] compared with the control group. Much more significant lower levels of inhibin A were Jbund in cases of threatened abortion and failing pregnancies [group A] compared with the cases of threatened abortion but ongoing pregnancies [group B]. The cutoff value of inhibin A was measured, using the receiving operator curve [Roc curve], it was 268.9 pg/mI with a sensitivity of 82.5% and a specificity of 90.1% at8 weeks, while it was 395.5 pg/mI with a sensitivity of 85.5% undo specificity of 90.5% at 10 weeks. From our study we concluded that, finding an abnormal low level of inhibin A in pregnant fimale with threatened abortion can predict poor pregnancy outcome. The expanding knowledge of the role of inhibins since the development of specific and sensitive assays has opened the field for their potential uses in clinical practice. Examining the role of inhib ins and other biochemical markers in early pregnancy ftzilure will lead to an improved understanding of the mechanism behind it and will aid in selection of patients in whom expectant management is appropriate