Clinical and Ultrasonic Aspects in the Diagnosis and Follow‐Up of Patients with Early Pregnancy Failure

Abstract

The value of some central clinical and ultrasonic findings at the time of threatened abortion was examined in 525 patients in the 6th-20th weeks. The outcome of the pregnancy was delivery in 45 per cent of all the cases. A duration of the first bleeding of 3 days or more predicted abortion significantly more often than did a shorter bleeding episode. A positive detection of fetal life signs by ultrasound signified a successful outcome for the pregnancy in 87 per cent of the patients. The anamnestic duration of pregnancy often seemed to deviate from the real weeks, requiring correction by ultrasonic methods. Forty-eight per cent of the cases with various pathologic forms of early pregnancy were evacuated on the basis of ultrasonic findings without waiting for the unavoidable spontaneous abortion. The later course of the pregnancies with a successful outcome revealed an 8 per cent frequency of premature deliveries, signifying careful observation of the patients in this respect. The relatively high frequency of perinatal mortality (3.4 per cent) seemed to be associated with the prematurity.

Symptoms of an Intrauterine Hematoma Associated with Pregnancy Complications: A Systematic Review

“…Similar to that before, a study enrolling 22 patients with persistent SCH until delivery also reported the pregnancies ended in abortion or premature labor finally [1]. The incidence of persistent SCH until delivery was 0.46%, which was much lower than that of a hematoma detected in the first trimester (4–48%) [47]. Because almost half of the women with an IUH did not experience vaginal bleeding, Tower and Regan [5] then postulated that most hematomas would be resolved spontaneously.…”

Value of Schwangerschaftsprotein 1 (SP1) and pregnancy‐associated plasma protein‐A (PAPP‐A) in the clinical management of threatened abortion

“…This is not confirmed in our study where 9 out of 23 viable and 15 out of 3 1 non-viable pregnancies had < 3 days bleeding. The progress of our 23 patients diagnosed as having viable pregnancies was, however, similar to the 87% successful pregnancies reported by Joupilla (1980). In our study only one patient aborted subsequently at 16 weeks, one had a preterm neonatal death at 28 weeks, two had successful deliveries at 36 weeks and the remaining 19 had live term deliveries.…”

“…The 16 high PAPP-A values in this same group (51% of the group) represent a mixture of conditions. Joupilla (1980) claimed that abortion was more likely if the first vaginal bleeding lasted for 2 3 days than if it ceased before 3 days. This is not confirmed in our study where 9 out of 23 viable and 15 out of 3 1 non-viable pregnancies had < 3 days bleeding.…”

“…below -2SD) but only 67% success with the prediction for viability. Joupilla et al (1980) assayed both single and serial samples for SP,. Their results therefore are not strictly comparable but a high predictive value for SP, was also shown.…”

Fetal growth delay in threatened abortion: an ultrasound study

“…It is uniformly reported that patients with threatened abortion in whom ultrasound examination shows a live fetus will have a successful outcome of pregnancy in approximately 90% of patients (Robinson 1975: Jouppila 1980. In our series the figure is 88%.…”