Clinical value of serum homocysteine, folate, and ultrasonography detection of yolk sac in predicting the outcome of threatened abortion

Abstract

Background: To investigate the clinical value of serum homocysteine (Hcy), folate, and ultrasonography detection of yolk sac in predicting the outcome of threatened abortion.Methods: Ninety-eight pregnant women within 12 weeks of gestation were included in the study. Of these subjects, 29 presented with threatened abortion and were considered the case group (n=29). The other 69 subjects showed as a normal pregnancy were the control group (n=69). The case group was followed up with at 28 weeks of gestation, and further divided into inevitable abortion group (IA, n=9) and successful fetus protection group (SFP, n=20). The yolk sacs of the included cases were measured by ultrasonography. The serum Hcy and folate levels of the included cases were measured by an enzyme cycling assay and chemiluminescent immunoassay, respectively. The yolk sac visualization rate and serum Hcy and folate levels were compared between the two case groups and used as a predicting reference for the outcome of threatened abortion. Results: The yolk sac visualization rates detected by ultrasonography were 97.1% (67/69) for the control group and 69.0% (20/29) for the threatened abortion group, with a statistical difference (p<0.05). For the IA and SFP groups, the visualization rates were 22.2% (2/9) and 90.0% (18/20) respectively, with a statistical difference (p<0.05). The serum Hcy levels in the threatened abortion group were significant elevated compared with control group (6.1±2.0 μmol/L vs 4.5±1.3 μmol/L), with a statistical difference (p<0.05). However, the serum levels of folat in the threatened abortion group were significantly decreased compared with the control group (15.5±4.2 nmol/L vs 19.1±4.7 nmol/L), with a statistical difference (p<0.05). The serum levels of Hcy and folate were 7.5±1.7 μmol/L and 12.7±4.2 nmol/L for the IA group, which were statistically different compared to the SFP group (p<0.05). The predictive sensitivity for the outcome of threatened abortion based on serum Hcy and folate levels were 85.0% and 75.0%, with a predictive specificity of 66.7% and 88.9% respectively. Conclusion: Serum Hcy and folate levels were quite different in threatened abortion pregnant woman compared to the control group. Serum Hcy and folate level detection combined with ultrasonography detection of yolk sac can provide useful information for threatened abortions

Is Sonographic Morphology of Early Embryonic Complex Can Predict of Pregnancy Outcome?

“…A yolk sac's diameter is typically 2-5 mm between weeks 6-8 of pregnancy and continues to expand until week 10 of pregnancy (7) . When the mean gestational sac diameter is greater than 8 mm without a yolk sac, or greater than 16 mm without an embryo, a blighted ovum can be definitively diagnosed using transvaginal sonography.…”

“…Approximately 30-40% of all implantations are lost to spontaneous abortion, and the vast majority of these abortions occur within the first trimester (6) . If fetal cardiac activity has been established, however, the chance of a spontaneous abortion is reduced to 2-5% (7) .…”