[Diagnosis and treatment of early pregnancy complications (proceedings)]

The value of ovarian and placental steroid determinations in abnormal early pregnancy

Concentrations of estradiol (E2), progesterone (P), and 170H-progesterone (170H-P) were measured by radioimmunoassay in serum samples obtained from a group of 98 women with threatened (n = 60), incomplete (n = 22) or missed (n = 16) abortion between the 4th and 17th week of pregnancy. The diagnosis was based on the clinical symptoms and the results of ultrasound scanning. In threatened abortion 54, out of 60 E2 values were within the 95% normal range, including most of the cases in which abortion occurred later. In incomplete abortion 18 of 21 E2 values were below the lower 95% confidence limit. In missed abortion, 11 of 15 E2 values were abnormal, being below the 95% normal range. Similar patterns in women with threatened, incomplete or missed abortion can be observed for values of P and 170H-P. Our results indicate that serum determinations of ovarian and placental steroids in women with early pregnancy failure are not of great clinical value.

Log normal distribution of ovarian and placental steroid values in early human pregnancy

Concentrations of estradiol, progesterone, 17OH-progesterone were measured by radioimmunoassay in individual serum samples obtained from a group of 304 women with normal gestations between the 4th and 17th week of pregnancy. Values obtained underwent statistical analysis in order to determine the arithmetic mean and the 95% normal range (+/- two standard deviations). It was noted hereby that the spread of values above the mean was greater than that below the mean, and that very often the mean minus two standard deviations was either close to zero or negative. Therefore, the data for each hormone were analyzed for normality of the distributions by the chi-square test. For each hormone the chi-square test was significantly different (p less than 0.001) from the normal distribution (Gaussian). Subsequently, linear transformation by rankit analysis revealed the log-normal distribution of our data. Furthermore, rankit analysis was used as a graphical method to delineate a useful clinical range, which includes the mean and meaningful 95% confidence limits for estradiol, progesterone, and 17OH-progesterone in early normal pregnancies.