Biochemical risk assessment of first trimester miscarriage by evaluating serum estradiol progesterone and beta human chronic gonadotropin levels

Objective: The current study was carried out to predict outcome of first trimester pregnancy by evaluating serum estradiol, progesterone and beta human chorionic gonadotropin levels. Material and Methods: This cross-sectional study was conducted at the Department of Chemical pathology and endocrinology AFIP, for a period of six months (from January 2023 to June 2023). Non-probability consecutive sampling was used for the selection of participants. All females presented with singleton pregnancy of 05-07 weeks from 21-40 years age were asked to sign informed consent and enroll in study. All patients with assisted reproductive techniques facilitated pregnancy, known thyroid, diabetes and hypertension were excluded from the study. Chemical biomarkers including Serum beta HCG, estradiol and progesterone were compared at the time of 7-9 weeks and 10-12 weeks. Statistical analysis was performed using Mann Whitney U test and relative risk analysis and p-Value ≤ 0.05 was considered significance. Results: Median of Beta HCG at 7-9 weeks IU/L, Estradiol 7-9 weeks gestation, Beta HCG at 10-12 weeks IU/L, Estradiol at 11-12 weeks pmol/L and Progesterone at 11-12 weeks nmol/L were low in Miscarriages 6574.0 (9876.0 – 4321.0), 760.0 (913.3 – 634.0), 18356.0 (67893.0 – 15000.0), 1011.0 (1987.0 – 900.0) and 65.60 (164.0 – 32.50) respectively as compare to healthy groups and showed statistically highly significant difference as p values < 0.001. Median of Progesterone at 7-9 weeks nmol/L also low in Miscarriages group but showed non statistically significant difference as p value = 0.062. Conclusion: It was concluded that estradiol levels can effectively predict miscarriage in the first trimester, with higher sensitivity at 7-9 weeks. Early monitoring of estradiol can aid in identifying at-risk pregnancies, enabling timely interventions to improve outcomes. Keywords: First trimester miscarriage, Beta HCG, Estradiol, Progesterone