Fetal growth delay in threatened abortion: an ultrasound study

Mantoni, Margit; Pedersen, Jan Fog

doi:10.1111/j.1471-0528.1982.tb03653.x

Cited by 40 publications

(20 citation statements)

References 6 publications

(3 reference statements)

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“…Previous studies (Table ) have demonstrated the association between the smaller than expected embryonic CRL and the increased probability of subsequent miscarriage in women with intrauterine singleton viable pregnancies …”

Section: Discussionmentioning

confidence: 92%

“…Fetal growth delay in the first trimester can be diagnosed using either a cross‐sectional method or serial assessment of fetal biometry . The cross‐sectional method relies on an accurate recall of menstrual age and a regular menstrual cycle so that expected fetal size for gestation can be calculated.…”

Section: Discussionmentioning

confidence: 99%

“…Although some previous studies recruited only women with threatened miscarriage, the other studies including the present one did not consider threatened miscarriage as an inclusion criterion in order to increase the spectrum of the studied population …”

Section: Discussionmentioning

confidence: 99%

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Can a smaller than expected crown–rump length reliably predict the occurrence of subsequent miscarriage in a viable first trimester pregnancy?

Abuelghar

Fathi

Ellaithy

et al. 2013

J of Obstet and Gynaecol

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Objectives: To assess the prognostic value of smaller than expected early Crown-rump length (CRL) to predict the occurrence of subsequent first trimester miscarriage in women with singleton pregnancy conceived by in vitro fertilisation treatment with or without intracytoplasmic sperm injection (IVF/ICSI). Methods: A retrospective observational study of prospectively collected data of first trimester intra-uterine singleton pregnancies after an IVF/ICSI fresh cycle was conducted at a tertiary centre where embryonic transfer is performed at the cleavage stage. Real gestational age (GA) in days was calculated from the date of oocyte retrieval (plus 14 days). CRL was measured at 6 to 10 weeks by transvaginal ultrasound and only pregnancies viable at this stage were considered. GA from CRL, termed estimated GA, was calculated by the software (Astraia ®) in use. Discrepancy in days between real and estimated GA was compared between viable and miscarried pregnancies at 11-13 weeks. First trimester miscarriage rate was assessed according to cutoffs (-3,-5 and-7 days of estimated GA). Results: From 282 pregnancies, 256 (90.8%) were viable at 11 to 13 weeks. Miscarried pregnancies had greater discrepancy between real and estimated GA than viable pregnancies (-3.029 days [-4.756 to-1.302], p=0.001). Late first trimester miscarriage occurred in 12/37 (32%) of pregnancies when estimated GA was-3 days than real GA, in 7/12 (58%) when it was-5 days and in 4/7 (85%) when it was-7 days. Miscarriage rate was not influenced by maternal age (p=0.866) nor fertilisation treatment (IVF versus ICSI, p=0.824). Conclusions: There appears to be an association between a smaller than expected early CRL and a higher likelihood of first trimester miscarriage in singleton pregnancies conceived by IVF/ICSI. This data can be useful in clinical practice to assist in the decision of a re-evaluation by early scan. OP11.04 Should the beta hCG threshold level for ultrasound in the diagnosis of tubal ectopic pregnancies be abolished?

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Can a smaller than expected crown–rump length reliably predict the occurrence of subsequent miscarriage in a viable first trimester pregnancy?

Abuelghar

Fathi

Ellaithy

et al. 2013

J of Obstet and Gynaecol

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“…Ultrasound findings that have been associated with subsequent miscarriage include a slow embryonic heart rate, a small gestational sac diameter and a larger‐than‐expected yolk sac diameter 5,6 . Smaller‐than‐expected CRL has also been associated with subsequent pregnancy loss in studies involving women with threatened miscarriage and in women who have undergone assisted conception techniques 7–9 . One possible link between a small CRL and subsequent miscarriage is that chromosomal defects not only have a high intrauterine lethality rate 10 but can also be associated with fetal growth restriction in the first trimester of pregnancy 11,12 .…”

Section: Introductionmentioning

confidence: 99%

Evidence of early first‐trimester growth restriction in pregnancies that subsequently end in miscarriage

Mukri

Bourne

Bottomley

et al. 2008

BJOG

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Objectives To examine whether viable early pregnancies that subsequently end in miscarriage exhibit evidence of first-trimester growth restriction.Design Prospective cohort study.Setting Early pregnancy unit (EPU) of a teaching hospital.Population Women attending EPU between 5 and 10 weeks of gestation.Methods Women with spontaneously conceived intrauterine, viable singleton pregnancies with certain last menstrual period and regular cycles were included. The deviation between the observed and expected crown-rump length (CRL) for gestation was calculated and expressed as a z score. Pregnancies were followed up until the 11-14 week scan, and the deviation between those that remained viable and miscarried subsequently was calculated.Main outcome measures Viability at 11-14 week scan.Results Over 6 months, 316 women met the inclusion criteria. Twenty-four (7.4%) women were excluded. Of the remaining 292, the pregnancy remained viable in 251 (86%) and 41 (14%) suffered a miscarriage. At the first transvaginal ultrasound, the z score of the mean measured CRL for pregnancies that remained viable was -0.82, SD 1.46, while in pregnancies that subsequently miscarried the z score was -2.42 and the CRL was significantly smaller, SD 1.31 (P < 0.0001). In the latter group, the initial CRL was below the expected mean for gestational age in all women, while in 61% (25/41), the CRL was at least 2 SDs below the expected mean.Conclusions CRL was significantly smaller in pregnancies that subsequently ended in miscarriage. This suggests that early firsttrimester growth restriction is associated with subsequent intrauterine death.

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“…Growth of the embryo during the first trimester is an important predictor of pregnancy outcome, early growth restriction being predictive of miscarriage (Mantoni and Pedersen 1982;Mukri et al 2008;Reljic 2001;Smith et al 1998).The current standard of measuring embryonic growth involves a 2-D measurement of the crown rump length (CRL), which is plotted against the gestational age estimated from the time of the last menstrual period (LMP) (Hadlock et al 1992;Robinson 1973). Measurement of embryo volume would enable growth to be assessed more critically because it is a nonlinear, exponential phenomenon unlikely to be accurately reflected in a simple 2-D measure of distance.…”

Section: Introductionmentioning

confidence: 99%

A Novel Technique for the Semi-Automated Measurement of Embryo Volume: An Intraobserver Reliability Study

Sur

Jayaprakasan

Jones

et al. 2010

Ultrasound in Medicine & Biology

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Fetal growth delay in threatened abortion: an ultrasound study

Cited by 40 publications

References 6 publications

Can a smaller than expected crown–rump length reliably predict the occurrence of subsequent miscarriage in a viable first trimester pregnancy?

Can a smaller than expected crown–rump length reliably predict the occurrence of subsequent miscarriage in a viable first trimester pregnancy?

Evidence of early first‐trimester growth restriction in pregnancies that subsequently end in miscarriage

A Novel Technique for the Semi-Automated Measurement of Embryo Volume: An Intraobserver Reliability Study

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