Progesterone concentrations in the sera of patients with intact and aborted hydatidiform moles

Abstract

Earlier studies on urinary pregnanediol in patients with hydatidiform moles have produced contradictory and inconclusive reports. This paper presents the results of serum progesterone measurements in 60 cases of hydatidiform mole. Serum progresterone was assayed by the competitive protein-binding technique, and serum human chorionic gonadotropin (HCG) was measured by the hemagglutination-inhibition technique. Serum progesterone in 47 unaborted molar pregnancies ranged from 25.0 to 263 ng. per milliliter with a mean ± standard error of the mean (S.E.M.) of 109 ± 11.3 ng. per milliliter. In 13 patients with aborted moles, serum progesterone ranged from 0 to 60.5 ng. per milliliter with a mean ± S.E.M. of 18.8 ± 4.6 ng. per milliliter. Thus, serum progesterone in patients with intact moles was significantly higher than in those with aborted moles (p <0.0005). Progesterone concentrations in patients with unaborted molar pregnancies were higher than in normal pregnancy in 37 cases, within the limits of normal pregnancy values in 7, and below normal values in 3 cases. The mean serum progesterone in patients with intact moles was significantly higher than the mean of those with normal pregnancies at 9 to 10, 13 to 14, 15 to 16, 17 to 18, and 19 to 20 weeks' gestational age. The mean serum progesterone in 22 patients with unaborted hydatidiform moles with theca-lutein cysts (TLC) (mean ± S.E.M. = 136.1 ± 15.6 ng. per milliliter) was significantly higher than the mean in 25 patients with unaborted moles without TLC (mean ± S.E.M. = 83.0 ± 14.8 ng. per milliliter) (p <0.01). Likewise the mean serum progesterone in patients with aborted moles with TLC (30.2 ng. per milliliter) was higher than the mean in those with aborted moles without TLC (13.7 ng. per milliliter). There was no significant correlation between serum progesterone and uterine size (r = −0.007) and between serum progesterone and serum HCG (r = +0.0574). The potential value of elevated serum progesterone as a useful adjunct in the endocrine diagnosis of molar pregnancy, together with the probable source of the hormone, is discussed.