Predictive value of presence of amniotic sac without visible embryonic heartbeat in diagnosis of early embryonic demise

Dooley, William M; Braud, Lucrezia de; Thanatsis, Nikolaos; Memtsa, Maria; Jauniaux, Eric

doi:10.1002/uog.23533

Cited by 5 publications

(5 citation statements)

References 16 publications

(22 reference statements)

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“…Zu diesem Zeitpunkt liegt die SSL bei ca. 7-12 mm [9]. Mit fortschreitendem Gestationsalter fällt die Abortrate ab [10].…”

Section: Intakte Frühgraviditätunclassified

“…Wie im vorangegangenen Abschnitt beschrieben, sollte bei intakter Gravidität zu den entsprechenden Zeitpunkten ein Gestationssack, ein Dottersack und eine Embryonalstruktur mit Herzaktion darstellbar sein [4,5,6,7,8,9]. Auf die entsprechenden sonografischen und klinischen Befunde der verschiedenen Formen der gestörten Frühgravidität wird zugunsten der Übersichtlichkeit im jeweiligen Abschnitt des Artikels eingegangen.…”

Section: Sonografisch Und Klinischunclassified

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Gestörte Frühgravidität

Neuwald,

Lercher,

Fastenmeier

et al. 2023

Frauenheilkunde up2date

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“…Zu diesem Zeitpunkt liegt die SSL bei ca. 7-12 mm [9]. Mit fortschreitendem Gestationsalter fällt die Abortrate ab [10].…”

Section: Intakte Frühgraviditätunclassified

Section: Sonografisch Und Klinischunclassified

Gestörte Frühgravidität

Neuwald,

Lercher,

Fastenmeier

et al. 2023

Frauenheilkunde up2date

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“…Transvaginal ultrasonography is essential in the assessment of pregnancy of un known location, which can be due to early pregnancy, miscarriage, or ectopic pregnancy It is important to avoid making a false-positive diagnosis of miscarriage by using trans vaginal sonography, careful measurement of mean sac diameter and crown rump length and using safe cut-off values of these measurements in defining miscarriage [19]. A recen study showed that amniotic sac sign (the presence of amniotic sac without a live embryo is a reliable marker of miscarriage [20]. While the presence of an extrauterine gestationa sac with yolk sac and/or embryo with or without cardiac activity is indicative of ectopi pregnancy, the presence of an inhomogeneous adnexal mass ('blob' sign) or extrauterin sac-like structure ('bagel' sign) is very suggestive of a tubal ectopic pregnancy [21].…”

Section: Early Pregnancy Scanmentioning

confidence: 99%

Applications of Advanced Ultrasound Technology in Obstetrics

Leung¹

2021

Diagnostics

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Over the years, there have been several improvements in ultrasound technologies including high-resolution ultrasonography, linear transducer, radiant flow, three-/four-dimensional (3D/4D) ultrasound, speckle tracking of the fetal heart, and artificial intelligence. The aims of this review are to evaluate the use of these advanced technologies in obstetrics in the midst of new guidelines on and new techniques of obstetric ultrasonography. In particular, whether these technologies can improve the diagnostic capability, functional analysis, workflow, and ergonomics of obstetric ultrasound examinations will be discussed.

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“…Failed tubal sterilization and intrauterine devices can also increase the risk of an ectopic pregnancy ( Li et al , 2015 ). More recent reports from the UK showed a prevalence of 0.05% (1:2000) in women attending early pregnancy units (EPUs) ( Dooley et al , 2021 ) and 0.04% (1:2500) in ART pregnancies ( Santos-Ribeiro et al , 2016 ), probably reflecting the move towards single embryo transfers.…”

Section: Introductionmentioning

confidence: 99%

The risk of miscarriage following surgical treatment of heterotopic extrauterine pregnancies

Solangon

Otify

Gaughran

et al. 2022

Human Reproduction Open

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Study Question What is the risk of loss of a live normally sited (eutopic) pregnancy following surgical treatment of the concomitant extrauterine ectopic pregnancy? Summary Answer In women diagnosed with heterotopic pregnancies, minimally invasive surgery to treat the extrauterine ectopic pregnancy does not increase the risk of miscarriage of the concomitant live eutopic pregnancy. What Is Known Already Previous studies have indicated that surgical treatment of the concomitant ectopic pregnancy in women with live eutopic pregnancies could be associated with an increased risk of miscarriage. The findings of our study did not confirm that. Study Design, Size, Duration A retrospective observational case-control study of 52 women diagnosed with live eutopic and concomitant extrauterine pregnancies matched to 156 women with live normally sited singleton pregnancies. The study was carried out in three London Early Pregnancy Units covering a twenty-year period between November 2019 and April 2000. Participants/Materials, Setting, Methods All women attended early pregnancy units because of suspected early pregnancy complications. The diagnosis of heterotopic pregnancy was made on ultrasound scan and women were subsequently offered surgical or expectant management. There were three controls per each case who were randomly selected from our clinical database and were matched for maternal age, mode of conception and gestational age at presentation. Main Results And The Role Of Chance In the study group 49/52 (94%) women had surgery and 3/52 (6%) were managed expectantly. There were 9/52 (17%, 95% CI 8.2-30.3) miscarriages <12 weeks’ gestation and 9/49 (18%, 95% CI 8.7-32) miscarriages in those treated surgically. In the control group there were 28/156 (18%, 95% CI 12.2-24.8) miscarriages <12 weeks’ gestation, which was not significantly different from heterotopic pregnancies who were treated surgically (OR 1.03 95% CI 0.44-2.36). There was a further second trimester miscarriage in the study group and one in the control group. The live birth rate in the study group was 41/51 (80%, 95% CI 66.9-90.2) and 38/48 (79%, 95% CI 65-89.5) for those who were treated surgically. These results were similar to 127/156 (81%, 95% CI 74.4-87.2) live-births in the control group (OR 0.87, 95% CI 0.39-1.94). Limitations, Reasons For Caution This study is retrospective, and the number of patients is relatively small, which reflects the rarity of heterotopic pregnancies. Heterotopic pregnancies without a known outcome were excluded from analysis. Wider Implications Of The Findings This study demonstrates that in women diagnosed with heterotopic pregnancies, minimally invasive surgery to treat the extrauterine pregnancy does not increase the risk of miscarriage of the concomitant live eutopic pregnancy. This finding will be helpful to women and their clinicians when discussing the options for treating heterotopic pregnancies. Study Funding/Competing Interest(s) This work did not receive any funding. None of the authors has any conflict of interest to declare. Trial Registration Number Research Registry: researchregistry6430.

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Predictive value of presence of amniotic sac without visible embryonic heartbeat in diagnosis of early embryonic demise

Cited by 5 publications

References 16 publications

Gestörte Frühgravidität

Gestörte Frühgravidität

Applications of Advanced Ultrasound Technology in Obstetrics

The risk of miscarriage following surgical treatment of heterotopic extrauterine pregnancies

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