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During early pregnancy, about a third of women experience vaginal bleeding or pain. To predict if in such a case, a pregnancy is viable or non-viable pregnancy like a miscarriage, or an ectopic pregnancy, doctors currently rely on ultrasound tests. However, an ultrasound test can be sometimes inconclusive.  

A new study by a team of UK and Dutch researchers have found that measuring progesterone levels in women with pain or bleeding during early pregnancy is a useful way to help discriminate between a viable and a non-viable pregnancy, reports Medical Xpress.

The findings of the study suggest that a low level of progesterone in these women in most cases means a non-viable pregnancy.

While some studies conducted previously suggest that a single progesterone measurement during early pregnancy could be useful, the results were conflicting. Hence the researchers aimed at studying how accurately a single progesterone measurement in early pregnancy could differentiate between a viable and a non-viable pregnancy.

For the study, the researchers analyzed 26 studies involving 9,436 pregnant women. While seven of those studies looked at women with pain or bleeding and an inconclusive ultrasound assessment, 19 studies looked at women with pain or bleeding alone.

In order to minimize bias, differences in study quality were taken into consideration.

The analysis of the current study reveals that a single low progesterone measurement for women in early pregnancy accompanied with bleeding or pain can discriminate between a viable and a non-viable pregnancy when an ultrasound test proves to be inconclusive.

However, for those women who experienced pain or bleeding and did not have an ultrasound, the progesterone test proved less accurate in predicting viability of the pregnancy.

The researchers emphasize that there is a possibility of low progesterone levels in some viable pregnancies and that progesterone level measurement should be accompanied by another test to ascertain the accuracy of the diagnosis.

They also suggest that "this test is highly accurate when complemented by ultrasound and could be added to the existing algorithms for the evaluation of women with pain or bleeding in early pregnancy as it can accelerate diagnosis," the report says.

The study was published in the British Medical Journal.