THE ACCURACY OF SINGLE SERUM PROGESTERONE MEASUREMENT IN THE DIAGNOSIS OF ECTOPIC PREGNANCY - A METAANALYSIS

Serum progesterone measurement has been advocated as a diagnostic tool in the non-invasive diagnosis of ectopic pregnancy, To assess the acc uracy of a single serum progesterone measurement in the diagnosis of e ctopic pregnancy, a meta-analysis was performed incorporating 26 studi es evaluating the performance of single serum progesterone measurement in the diagnosis of ectopic pregnancy. A distinction was made in the diagnosis of pregnancy failure of any type versus viable intrauterine pregnancy and the diagnosis of ectopic pregnancy versus non-ectopic pr egnancy. The reported sensitivity and specificity differed between the studies. Since there was a clear negative correlation between sensiti vity and specificity, summary receiver-operating characteristic (ROC) curves could be estimated. The ROC curve for the diagnosis of pregnanc y failure versus viable intrauterine pregnancy showed a good discrimin ative capacity. Single serum progesterone measurement could not discri minate between ectopic pregnancy and non-ectopic pregnancy, It is conc luded that serum progesterone measurement can identify patients at ris k for ectopic pregnancy, who need further evaluation, but its discrimi native capacity is insufficient to diagnose ectopic pregnancy with cer tainty.