Correlation between hormonal levels and ultrasound in patients with threatened abortion.

96 women with threatened abortion were monitored by repeated ultrasonic examinations. Simultaneously plasma HCG, progesterone, estradiol and estriol levels were measured. 12 patients with blighted ovum had hormonal levels in the low normal range before the 8th week and abnormal values after the 10th week. 31 patients had abnormal ultrasonic morphology and absence of fetal heart movements. In half of these patients, estradiol was low even before vaginal bleeding. When vaginal bleeding occurred, all subjects who aborted later, except 1, had at least one abnormal hormonal value. In 4 cases, fetal life signs were detected only after the 10th week; hormonal levels remained normal, confirming the presence of a viable fetus. 31 patients had normal ultrasounds despite vaginal bleeding and arrived to term. Hormonal profiles were also normal. 18 patients had normal ultrasounds and aborted in the second trimester of pregnancy. Some of them had low normal hormonal levels. Others had a secondary decrease in hormonal levels (most often estrogen levels) which, in some cases, preceded the abnormality of the ultrasounds. It is concluded that ultrasounds and hormonal measurements are complementary. Ultrasounds alone gave a correct prognosis in 78% of the cases after a single examination. Caution is advised when fetal life signs are absent and termination of pregnancy is contemplated. Hormonal measurements may then confirm or refute the unfavorable prognosis. Also, hormonal measurements may provide some insight as to the subsequent evolution of a threatened pregnancy, even in the presence of normal ultrasounds. The therapeutic prospect of this knowledge is, however, still to be defined.