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KMID : 0358419770200010019
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Korean Journal of Obstetrics and Gynecology
1977 Volume.20 No. 1 p.19 ~ p.30
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Urinary Titration of Human Chorionic Gonadotopin and Ultrasonography for Estimation of Prognosis in Threatened Abortion
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이진우/Lee JW
허필형/나종구/최성기/Hur PH/Rha CG/Choi SK
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Abstract
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In threatened abortion fetal health and growth in utero has been assessed by several methods. Various hormonal concentrations produced by placenta including human chorionic gonadotropin(hCG), progesterone, estrogen, human placental lactogen(hPL) and their meta bolites in urine have been estimated. In addition morphological estimation of fetal growth by X-ray and morphological has been carried out. But hormonal and morphological studies mentioned above were not always conclusive in making a definitive estimation of prognosis in threatened abortion. The present study was designed to combine two selected methods of approach, i.e., estimation of urinary hCG as a barometer of placental physiology and ultrasonography as morphological estimation of fetal growth in utero. Twenty patients clinically diagnosed of threatened abortion and five clinically normal pregnant women as control group were evaluated throughout their entire course of pregnancy. The titers of urinary hCG and the ultrasonographic patterns of fetal growth were measured serially once a week until their clinical symptoms of threatened abortion ceased and compared with their ultimate outcome of pregnancy. The regression curve of urinary hCG titer estimated by Wide (1962) and that of growth of gestational sac and fetal head estimated by Hellman et al. (1969) were used as standard one. Each measurement of urinary hCG titer (6-20 weeks of gestation) was interpreted as normal or abnormal value according to the confidential limits described by Wide (1962). Each measurement of gestational sac (6-12 weeks of gestation) or biparietal diameter (12-20 weeks of gestation) was also interpreted as normal or abnormal value according to normal range described by Hellman(1969). Then twenty patients of threatened abortion were divided into four groups according to various interpretations of both measurements, and were compared with the course of control group in relation to ultimate outcome of pregnancy. The results were as follows: 1) In control group of 5 normal pregnancies all 32 measurements of urinary hCG titer except two were within confidential limits described by Wide (1962). And all 15 measurements of growth of gestational sac except one and all 19 measurements of growth of biparietal diameters except two were within normal limits described by Hellman et al (1969). 2) All those 6 patients who revealed normal values of both urinary hCG titer and ultrasonographic measurements ended in normal course of pregnancy. 3) While three of those who revealed normal values of urinary hCG titers with abnormal ultrasonographic measurements completed their pregnancies in normal term delivaries, one of them aborted. 4) While three of those who revealed abnormal values of urinary hCG titers with normal ultrasonographic measurements resulted in normal deliveries, two of them aborted. 5) All those who revealed abnormal values of both urinary hCG titers and ultrasonographic measurements ended in abortion. 6) For more reasonable assessment of the prognosis in threatened abortion we think it better not only to use both methods together than any single one but also to check serial measurement.
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KEYWORD
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