Significance of dynamically monitoring serum estrogen and β-human chorionic gonadotropin in early pregnancy assessment

Background: Spontaneous abortion occurs in 15% similar to 25% of clinical pregnancy. beta-human chorionic gonadotropin (beta-HCG) and progesterone (P) have been widely used in early pregnancy assessment, but their clinical significances are still controversial. Estradiol (E2) has not been used as widely as beta-HCG and P, and its value in predicting pregnancy outcome is unclear. Methods: In this retrospective study, two hundred early pregnancy women were divided into two groups according to their early pregnancy outcomes: the ongoing pregnancy group and inevitable abortion group. Serum E2 and beta-HCG levels and their growth rates were compared weekly. Results: Estradiol and beta-HCG of the ongoing pregnancy group were significantly higher than that of the inevitable abortion group from the 5th to 10th week of pregnancy. Taking 489.5 pg/mL in the 5th and 6th week, 590.5 pg/mL in the 7th week, and 614.5 pg/mL in the 8th week as cutoff levels of E2, the sensitivity and specificity for E2 to predict bad pregnancy outcome were 91.7% and 41.5%, 82.9% and 71.1%, 84.8% and 84.7%, 75.0% and 95.7%, respectively (P < .05). Both E2 and beta-HCG increased much more rapidly in the ongoing pregnancy group. 80% of the normal pregnancy women showed continuously increasing E2 level. Meanwhile, the inevitable abortion group presented E2 variation types as slow increase or fluctuation, continuous decline, and sudden drop, which account for 54.0%, 34.0%, and 12.0%, respectively. Conclusion: Low values and low growth rates of E2 and beta-HCG probably indicate bad pregnancy outcomes.

Automated summary

This retrospective study on 200 early pregnancy women found that the ongoing pregnancy group had significantly higher levels of E2 and beta-HCG from the 5th to 10th week of pregnancy compared to the inevitable abortion group. The growth rates of E2 and beta-HCG play an important role in predicting pregnancy outcomes.