Fetal loss following ultrasound diagnosis of a live fetus at 6–10 weeks of gestation

Makrydimas, George; Sebire, Neil J.; Lolis, D.; Vlassis, N; Nicolaides, Kypros H.

doi:10.1002/uog.204

Cited by 93 publications

(60 citation statements)

References 29 publications

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“…We chose to use the middle because the thickness of the yolk sac wall may vary with the use of image compounding, harmonics and gain setting, resulting in systematic under-or overestimation of YSD when the measurements are taken in-to-in or out-to-out. Our findings on GSD are similar to those of the largest and most recent of the previous studies [14,27,34,47,49] .…”

Section: Comparison Of Reference Ranges With Previous Studiessupporting

confidence: 81%

Normal Ranges of Embryonic Length, Embryonic Heart Rate, Gestational Sac Diameter and Yolk Sac Diameter at 6–10 Weeks

et al. 2010

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Objectives: To construct normal ranges for embryonic crown-rump length (CRL), heart rate (HR), gestational sac diameter (GSD) and yolk sac diameter (YSD) at 6–10 weeks of gestation. Methods: We examined 4,698 singleton pregnancies with ultrasound measurements of CRL, HR, GSD and YSD at 6–10 weeks and CRL at 11–13 weeks resulting in the live birth after 36 weeks of phenotypically normal neonates with birth weight above the 5th centile. Gestational age was derived from CRL at the 11- to 13-week scan using the formula of Robinson and Fleming. Regression analysis was used to establish normal ranges of CRL, fetal HR, GSD and YSD with gestation, and fetal HR, GSD and YSD with CRL. Results: At 6–10 weeks there were significant quadratic associations between CRL, GSD, YSD and gestation and between HR, GSD, YSD and CRL, and a cubic association between HR and gestation. The estimated gestation from CRL was the same as that of Robinson and Fleming for a CRL of 10.2–36.5 mm, but the formula of Robinson and Fleming underestimated the gestation by 1 day for a CRL 7.4–10.2 mm and this increased to 9 days for a CRL of 1 mm. Conclusion: This study established normal ranges for early pregnancy biometry.

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Section: Comparison Of Reference Ranges With Previous Studiessupporting

confidence: 81%

Normal Ranges of Embryonic Length, Embryonic Heart Rate, Gestational Sac Diameter and Yolk Sac Diameter at 6–10 Weeks

et al. 2010

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“…Possibly, the number of spontaneous miscarriages was overestimated in the reference that we used, because early dating ultrasound was not routine practice in that time [31]. However, we wanted to calculate the miscarriage risk in the specific time windows in which NIPT was offered, and we could not obtain this information from more recent studies [32,33]. No change in the order of preference was seen if the miscarriage risks in fetuses without Down syndrome were much lower, i.e.…”

Section: Discussionmentioning

confidence: 99%

Advantages and Disadvantages of Different Implementation Strategies of Non-Invasive Prenatal Testing in Down Syndrome Screening Programmes

Mersy¹,

Die-Smulders²,

Coumans

et al. 2015

Public Health Genomics

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Background: Implementation of non-invasive prenatal testing (NIPT) in Down syndrome screening programmes requires health policy decisions about its combination with other tests and its timing in pregnancy. Aim: Our aim was to aid health policy decision makers by conducting a quantitative analysis of different NIPT implementation strategies. Methods: Decision trees were created to illustrate all plausible alternatives in a theoretical cohort of 100,000 pregnant women in five screening programmes: classical screening by the first-trimester combined test (FCT), pre-selection of high-risk women prior to NIPT by the FCT, NIPT as the first screening test at 10 weeks and at 13 weeks, and the simultaneous conductance of NIPT and the FCT. Results: Pre-selection by FCT prior to NIPT reduces the number of amniocenteses to a minimum because of a reduction of false-positive NIPT results. If NIPT is the first screening test, it detects almost all fetal Down syndrome cases. NIPT at 10 weeks reassures women early in pregnancy, while NIPT at 13 weeks prevents unnecessary tests due to spontaneous miscarriages and allows for immediate confirmation by amniocentesis. Conclusion: Every implementation strategy has its advantages and disadvantages. The most favourable implementation strategy may be NIPT as the first screening test at 13 weeks, offering the most accurate screening test for Down syndrome, when the risk for spontaneous miscarriage has declined remarkably and timely confirmation by amniocentesis can be performed.

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“…A large YS may exist in a normal pregnancy; however, if the fetal pole is undetectable, then a YS >4.2 mm is a likely indicator of miscarriage (7). The predictive value of an enlarged YS alone has been variable (3,8,9). The major limitations of these studies were the small number of subjects with abnormal YS diameters and lack of demographic data associated with early pregnancy loss.…”

mentioning

confidence: 97%

Detection of enlarged yolk sac on early ultrasound is associated with adverse pregnancy outcomes

Berdahl

Blaine

Voorhis

et al. 2010

Fertility and Sterility

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Fetal loss following ultrasound diagnosis of a live fetus at 6–10 weeks of gestation

Abstract: Objective

Cited by 93 publications

References 29 publications

Normal Ranges of Embryonic Length, Embryonic Heart Rate, Gestational Sac Diameter and Yolk Sac Diameter at 6–10 Weeks

Normal Ranges of Embryonic Length, Embryonic Heart Rate, Gestational Sac Diameter and Yolk Sac Diameter at 6–10 Weeks

Advantages and Disadvantages of Different Implementation Strategies of Non-Invasive Prenatal Testing in Down Syndrome Screening Programmes

Detection of enlarged yolk sac on early ultrasound is associated with adverse pregnancy outcomes

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