{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T05:28:26Z","timestamp":1773984506090,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2010,4,23]],"date-time":"2010-04-23T00:00:00Z","timestamp":1271980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2010,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To find the best predictor of the viability of intrauterine pregnancies of uncertain viability (IPUVs). An IPUV is defined as an empty intrauterine gestational sac measuring less than 20 mm in diameter or an intrauterine gestational sac containing a fetal pole with a crown\u2013rump length (CRL) of less than 6 mm with no fetal cardiac activity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational study comparing the following two markers for the prediction of viability in IPUVs: human chorionic gonadotropin (hCG) ratio (hCG 48 h : hCG 0 h); and serum progesterone at first presentation. All women classified with a pregnancy of unknown location (PUL) were followed up until final diagnosis: failing PUL, viable or non\u2010viable intrauterine pregnancy (IUP), or ectopic pregnancy. Those PULs found to have an IPUV at follow\u2010up transvaginal ultrasound scan (TVS) were included in the final analysis. Receiver\u2013operating characteristics (ROC) curves were used to compare the performance of the hCG ratio and progesterone. Using logistic regression, the added value of combining both variables over single\u2010variable prediction was also evaluated. Missing values were imputed using multiple imputation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 12 572 consecutive first\u2010trimester women were scanned. Of these, 1003 (8%) women were classified as having PULs at first scan; 379 (37.8%) PULs were confirmed as IPUVs at follow\u2010up scan, with 82.6% (276\/334) found to be viable IUPs and 17.4% (58\/334) non\u2010viable IUPs on a second follow\u2010up scan. Forty\u2010five PULs were lost to follow\u2010up. For prediction of viability in IPUVs, the area under the ROC curve (AUC) for the hCG ratio was 0.756 (95% CI, 0.686\u20130.826) whilst that for progesterone was 0.678 (95% CI, 0.603\u20130.753). The difference in AUC was 0.078 (95% CI, 0.014\u20130.169, <jats:italic>P<\/jats:italic> = 0.098), suggesting that the hCG ratio was at least as good as initial progesterone. Furthermore, there was no clear threshold for initial progesterone, whilst for hCG a ratio of 2 was suggested (sensitivity 78%, specificity 67%). Logistic regression modeling demonstrated that progesterone did not improve the discriminatory power of the hCG ratio (AUC = 0.758).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The hCG ratio may be preferred to single measurements of progesterone to predict the viability of IPUVs in the PUL population. Copyright \u00a9 2010 ISUOG. Published by John Wiley &amp; Sons, Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.7669","type":"journal-article","created":{"date-parts":[[2010,4,23]],"date-time":"2010-04-23T11:28:36Z","timestamp":1272022116000},"page":"656-661","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Viability of intrauterine pregnancy in women with pregnancy of unknown location: prediction using human chorionic gonadotropin ratio vs. progesterone"],"prefix":"10.1002","volume":"35","author":[{"given":"T.","family":"Bignardi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Condous","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Kirk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Van Calster","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Van Huffel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Timmerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Bourne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,5,28]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/uog.2838"},{"key":"e_1_2_6_3_2","unstructured":"Royal College of Obstetricians and Gynaecologists2006;The Management of Early Pregnancy Loss. 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