Spontaneous pregnancy reaches viability after low first trimester serum progesterone: a case report.

Progesterone is produced by the corpus luteum until completion of the luteal-placental shift at approximately 6-10 weeks following last menstruation. Studies have shown that first trimester progesterone levels are predictive of pregnancy viability, and some authors support a level of 5 ng/mL as an absolute threshold to indicate viability. A 47-year-old woman with recurrent pregnancy loss was noted to have a very low first trimester progesterone level (1.2 ng/mL), but the pregnancy progressed to viability. She unfortunately delivered an intrauterine fetal demise at 27 weeks and 3 days' gestation. A single serum progesterone level of < 5 ng/mL is suggestive, but not diagnostic, of a nonviable pregnancy. Routine uterine curettage during the evaluation of a pregnancy of unknown location using this level as an absolute cutoff may result in the interruption of a desired, viable pregnancy.

Citation

John R Crochet, Mary C Peavey, Thomas M Price, Millie A Behera. Spontaneous pregnancy reaches viability after low first trimester serum progesterone: a case report. The Journal of reproductive medicine. 2012 Mar-Apr;57(3-4):171-4

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PMID: 22523880

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