Early pregnancy failure: study by ultrasonic and hormonal methods.

The value of ultrasonic and hormonal methods [plasma human chorionic gonadotropin (hCG), estradiol (E2), and progesterone (P)] was examined in 188 patients exhibiting different forms of early pregnancy failure. A negative ultrasonic result in the detection of fetal life signs after 9 weeks' gestation signified an unsuccessful outcome for the pregnancy in 100% of cases. On the other hand, the ultrasonic demonstration of fetal life predicted delivery in 90% of cases despite symptoms of threatened abortion. Pathologic levels of hCG or P signified a later miscarriage in 93% of cases, and their combination correlated with a 100% failure rate. In the diagnosis of ectopic pregnancy the combined application of ultrasound and plasma hCG levels seemed to be very useful; however it appears that the detection of blighted ovum should be based on the ultrasonic scanning only. The results of the present study indicate that ultrasonic examination can be regarded as the basic diagnostic method in the evaluation of early pregnancy failure. The determination of plasma trophoblastic hormones (especially hCG) seems to add valuable information to the ultrasonic findings in the actual diagnosis and evaluation of the later course of pregnancy only until 9 weeks' gestation.