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Serum biomarkers may help predict successful misoprostol management of early pregnancy failure.
Schreiber, Courtney A; Ratcliffe, Sarah J; Quinley, Kelly E; Miller, Carrie; Sammel, Mary D.
Afiliación
  • Schreiber CA; Penn Family Planning and Pregnancy Loss Center, Penn Medicine, University of Pennsylvania, Perelman School of Medicine, 1000 Courtyard, 3400 Spruce Street, Philadelphia, PA 19104, United States. Electronic address: schreibe@upenn.edu.
  • Ratcliffe SJ; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, United States.
  • Quinley KE; Highland General Hospital | Alameda County Health System, United States.
  • Miller C; Perelman School of Medicine, University of Pennsylvania, United States.
  • Sammel MD; Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Perelman School of Medicine, United States.
Reprod Biol ; 15(2): 79-85, 2015 Jun.
Article en En | MEDLINE | ID: mdl-26051455
In order to simplify management of early pregnancy loss, our goal was to elucidate predictors of successful medical management of miscarriage with a single dose of misoprostol. In this secondary analysis of data from a multicenter randomized controlled trial, candidate biomarkers were compared between 49 women with missed abortion who succeeded in passing their pregnancy with a single dose of misoprostol and 46 women who did not pass their pregnancy with a misoprostol single dose. We computed the precision of trophoblastic protein and hormone concentrations to discriminate between women who succeed or fail single dose misoprostol management. We also included demographic factors in our analyses. We found overlap in the concentrations of the individual markers between women who succeeded and failed single-dose misoprostol. However, hCG levels ≥ 4000 mIU/mL and ADAM-12 levels ≥ 2500 pg/mL were independently associated with complete uterine expulsion after one dose of misoprostol in our population. A multivariable logistic model for success included non-Hispanic ethnicity and parity <2 in addition to hCG ≥ 4000 mIU/mL and ADAM-12 ≥ 2500 pg/mL and had an area under the receiver operating characteristic (ROC) of 0.81 (95% confidence interval: 72-90%). Categorizing women with a predicted probability of ≥ 0.65 resulted in a sensitivity of 75.0%, specificity 77.1% and positive predictive value of 81.8%. While preliminary, our data suggest that serum biomarkers, especially when combined with demographic characteristics, may be helpful in guiding patient decision-making regarding the management of early pregnancy failure (EPF). Further study is warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxitócicos / Aborto Incompleto / Misoprostol / Aborto Retenido / Gonadotropina Coriónica Humana de Subunidad beta / Proteínas ADAM / Proteínas de la Membrana Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Reprod Biol Asunto de la revista: MEDICINA REPRODUTIVA Año: 2015 Tipo del documento: Article Pais de publicación: Polonia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Oxitócicos / Aborto Incompleto / Misoprostol / Aborto Retenido / Gonadotropina Coriónica Humana de Subunidad beta / Proteínas ADAM / Proteínas de la Membrana Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Pregnancy Idioma: En Revista: Reprod Biol Asunto de la revista: MEDICINA REPRODUTIVA Año: 2015 Tipo del documento: Article Pais de publicación: Polonia