A Yolk Sac Larger Than 5 mm Suggests an Abnormal Fetal Karyotype, Whereas an Absent Embryo Indicates a Normal Fetal Karyotype

Yoneda, Satoshi; Shiozaki, Arihiro; Yoneda, Noriko; Sameshima, Azusa; Ito, Mika; Saito, Tomoko; Nakashima, Akitoshi; Yokosuka, Osamu; Kigawa, Mika; Takamori, Ryosuke; Shinagawa, Yasuhiro; Saito, Shigeru

doi:10.1002/jum.14467

Cited by 9 publications

(7 citation statements)

References 44 publications

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“…According to this single study, the majority of the EPL with enlarged YS are at high risk of chromosomal abnormalities of which trisomy 22 were especially high. During the submission of this study, a newly published cohort study including 151 patients with pregnancy <12 weeks’ gestation echoed our finding that an enlarged yolk sac suggested an abnormal fetal karyotype, whereas an pre-embryonic feature was with less association 32 …”

Section: Discussionsupporting

confidence: 66%

Do specific ultrasonography features identified at the time of early pregnancy loss predict fetal chromosomal abnormality? – A systematic review and meta-analysis

Huang¹,

Zhu²,

Tang³

et al. 2019

Genes & Diseases

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To investigate the association of specific ultrasonography features identified during the diagnosis of early pregnancy loss (EPL) and abnormal karyotype. This was a systematic review and meta-analysis conducted in accordance with PRISMA criteria. We searched PubMed, Cochrane and Ovid MEDLINE from 1977 to Jan 2017 to identify the articles that described EPL with karyotype and ultrasonography features. Risk differences were pooled to estimate the chromosomal abnormality rates in ultrasonography features, including pre-embryonic, enlarged yolk sac (YS), short crown rump length (CRL), small gestational sac (GS), symmetrical arrested growth embryo, or gestational sac with only a YS. Quality assessment of included studies was performed using Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklists for Observational Studies (2007 version). Thirteen studies were included in the meta-analysis. Chromosomal abnormality was more likely to occur in embryonic EPL and enlarged YS. On the other hand, short CRL, small GS, symmetrical arrested growth embryo, or gestational sac with only a YS, were not associated with an increased risk of fetal chromosomal abnormality. Ultrasonography features at the time of diagnosis of EPL have limited predictive value of fetal chromosomal abnormality.

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Section: Discussionsupporting

confidence: 66%

Do specific ultrasonography features identified at the time of early pregnancy loss predict fetal chromosomal abnormality? – A systematic review and meta-analysis

Huang¹,

Zhu²,

Tang³

et al. 2019

Genes & Diseases

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show abstract

“…However, all pregnancies with a large YS were lost before 10 weeks' gestation, which could defend genetically abnormal pregnancies being lost within the first trimester. The present study also described a new YS abnormality, such as a small YS, which was previously reported as a risk for miscarriage only by Yoneda et al . The fact that a small YS was associated with a later pregnancy loss would explain this abnormality associated not with genetic abnormalities, but rather with placental abnormalities, such as placental insufficiency.…”

Section: Discussionsupporting

confidence: 73%

“…While the etiology of an abnormal YS diameter is largely unknown, approximately 18.2–66.2% of large YS diameters greater than 5–6 mm have been associated with abnormal karyotypes . In the present study, there was insufficient genetic data reported, therefore we were unable to correlate YS findings with genetic abnormalities.…”

Section: Discussionmentioning

confidence: 70%

“…Prior studies have established YS increased dimension as a reliable predictor of pregnancy outcome . Unlike these previous studies which were limited by their retrospective, cross‐sectional evaluation with a single ultrasound per patient, our investigation utilized multiple ultrasounds in the same patient to accurately represent all gestational ages in each patient, making our study the first to longitudinally evaluate the changes in YS dimension in the same patient.…”

Section: Discussionmentioning

confidence: 99%

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Pilot study establishing a nomogram of yolk sac growth during the first trimester of pregnancy

Detti

Roman

Goedecke

et al. 2019

J of Obstet and Gynaecol

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Aim: The yolk sac (YS) has been reported as a reliable predictor of adverse pregnancy outcomes, however, it has always been evaluated cross-sectionally with a single ultrasound per patient. We sought to validate the use of YS dimensions in serial ultrasounds throughout the first 10 weeks of singleton and multiple gestations.Methods: This was a prospective cohort study where YS diameters were serially obtained with 2D ultrasound in singleton and multiple gestations from 5 to 11 weeks. Nonparametric test were used for comparisons with P < 0.05 indicating significance. Results: One hundred ninety-three patients were included, 42 twins (3 monochorionic and 39 dichorionic), 2 triplets (monochorionic twins plus a singleton) and 148 singleton pregnancies (238 total fetuses). There was no difference in YS dimensions in singleton versus multiple pregnancies. Starting at 5 weeks' gestation, the YS increased 0.4 mm (95% CI 0.3-0.5 mm) per week until 10 weeks' gestation. Forty-five fetuses were lost in the first trimester. The risk of pregnancy loss was higher with a large YS until 8 weeks (P ≤ 0.001), while after 8 weeks it was higher with a small YS (P < 0.005). Conclusion: We established a nomogram of YS development during the first 10 weeks of pregnancy. The YS reliably detected pregnancies that ended in loss as early as 6 weeks' gestation. The YS was either smaller or larger than in ongoing pregnancies. While all pregnancies with large YS were lost within 10 weeks, those with smaller YS were lost beyond the first 10 weeks.

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“…Seit den 1990er-Jahren gilt ein auffällig großer Dottersack (mehr als 6 mm Durchmesser) als ungünstiges prognostisches Zeichen für den weiteren Verlauf der Schwangerschaft [10]. Es gibt aber zahlreiche Berichte von normalen Schwangerschaftsverläufen und gesun- den Neugeborenen, bei denen in der Frühschwangerschaft ein auffällig großer Dottersack beobachtet wurde.…”

Section: Dottersack Als Prognosefaktorunclassified

Der Dottersack – ein wichtiger Marker beim Ultraschall in der Frühschwangerschaft

Brezinka

2019

J. Gynäkol. Endokrinol. AT

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ist ein wenig beachteter Nebenbefund beim Ultraschall in der Frühschwangerschaft. Dieser wichtige Begleiter des winzigen Kindes übernimmt eine Zeitlang seine Blutproduktion, bevor er dann ab der 10. SSW langsam obliteriert. Im Ultraschall ist der Dottersack ein wichtiges Orientierungsmerkmal und eine diagnostische Hilfe. Das allererste Zeichen einer intrauterinen Schwangerschaft, das wir im Ultraschall erkennen, ist die meist kreisrunde, echoarme Struktur, die im Ultraschalljargon "Fruchtsack" genannt wird. Der Fruchtsack entsteht zwar durch den Embryo, er ist genau genommen ein vom mütterlichen Endometrium gebildetes "Drumherum", in dem sich die Schwan

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A Yolk Sac Larger Than 5 mm Suggests an Abnormal Fetal Karyotype, Whereas an Absent Embryo Indicates a Normal Fetal Karyotype

Abstract: At the point of early miscarriage diagnosis, a yolk sac larger than 5 mm suggests an abnormal fetal karyotype, whereas an absent embryo indicates a normal fetal karyotype.

Cited by 9 publications

References 44 publications

Do specific ultrasonography features identified at the time of early pregnancy loss predict fetal chromosomal abnormality? – A systematic review and meta-analysis

Do specific ultrasonography features identified at the time of early pregnancy loss predict fetal chromosomal abnormality? – A systematic review and meta-analysis

Pilot study establishing a nomogram of yolk sac growth during the first trimester of pregnancy

Der Dottersack – ein wichtiger Marker beim Ultraschall in der Frühschwangerschaft

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