Corpus Luteum and Uterine Artery Doppler With Serum P and CA125 in Threatened Abortion

Study Overview
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Brief Summary
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The purpose of this study is to determine whether assessing color doppler of corpus luteum and uterine artery is useful in predicting patients who will complete pregnancy. The investigators will add to this the usefulness of serum progesterone and CA125 in prediction.

Detailed Description
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The introduction of Doppler ultrasound in obstetrics has allowed evaluating hemodynamic characteristics from the first trimester of pregnancy. For example, Kurjak et al.,in one of the first studies using transvaginal pulsed-wave Doppler ultrasound in early pregnancies, identified the uterine arteries in 100% of the patients. The flow blood of the corpus luteum was identified in 75% patients. The measures obtained by Doppler ultrasonography that may have prognostic value to the evolution of pregnancy include uteroplacental blood flow, also known as trophoblastic flow. Jaffe et al. reported that abnormal Doppler findings were associated with a significantly higher prevalence of complicated pregnancies, among women with abnormal Doppler findings, 43% ended in miscarriage, whereas among women with normal findings only 1.4% of women miscarried.Progesterone plays a crucial role in the maintenance of pregnancy. In the presence of sufficient progesterone levels during pregnancy, lymphocytes synthesize a mediator called progesterone induced blocking factor (PIBF), which is anti-abortive in mice . Besides inducing secretary changes in the endometrium and supporting early pregnancy, it modulates the maternal immune response to prevent fetal rejection and relaxes the uterine smooth muscles .CA-125, well-known as a tumor marker for epithelial ovarian cancer , is a high molecular weight glycoprotein that is produced not only by ovarian cancer, but also by nonovarian tumors, normal epithelia of the peritoneum, the endometrium, the fallopian tube, and the ovary. Because CA-125 is also produced by the endometrium, some authors suggest that CA-125 can be used as a marker for endometrial receptivity in patients undergoing IVF . Its role as a predictor for pregnancy outcome is controversial .

Official Title
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Color Doppler of CL and Uterine Artery With Serum Progesterone and CA125 in Threatened Abortion

Conditions
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Threatened Abortion

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients with pregnancy between 8 to 20 weeks of gestation, who were diagnosed with threatened abortion. Exclusion Criteria: patients with multiple pregnancies, molar pregnancy, ectopic pregnancy, amenorrhea with different etiologies of pregnancy, maternal history of systemic diseases and uterine anatomic abnormalities patients who did not have their outcome data through week 20 of gestation due to relocation.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Threatened abortion<br>Pregnant patients > 8 weeks gestation coming to the ANC clinic with mild vaginal bleeding but healthy viable intrauterine pregnancy. Vaginal color doppler for uterine artery and corpus luteum together with serum progesterone and CA125 will be assessed. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Viable fetus (According to WHO viable fetus >500 gm or > 20 weeks) | The investigators will assess how many patients in both groups reached viability of fetus. According to WHO viable fetus >500 gm or > 20 weeks. | from 20 weeks till 21 weeks gestation | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Resistance index of uterine artery and corpus luteum | Vaginal color doppler of uterine artery and corpus luteum for all pregnant patients in the study at first visit in ANC clinic . | from 8 weeks till 20 weeks | 
| serum CA125 and progesterone | serum CA125 and progesterone will be done for all pregnant patients at first visit in ANC clinic | from 8 weeks till 20 weeks gestation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CA 125, Progesterone, Doppler, Corpus Luteum