Sonographic and Doppler characteristics of the corpus luteum: can they predict pregnancy outcome?

Abstract

Objective. To determine whether there is a relationship between gray scale or Doppler characteristics of the corpus luteum and first-trimester pregnancy outcome. Methods. We conducted a prospective study of patients with spontaneous singleton pregnancies between 5 and 8 weeks' gestation. The corpus luteum size, sonographic appearance, resistive index, and peak systolic velocity were measured on transvaginal sonography. Maternal use of exogeneous progesterone was recorded. Only patients with known first-trimester outcome were included. Results. There were 201 study patients. The corpus luteum could be visualized in 197 (98%) and had a mean ± SD size of 1.9 ± 0.6 cm, a mean resistive index of 0.50 ± 0.08, and a peak systolic velocity of 20.5 ± 11.2 cm/s. There were 151 first-trimester survivors (75.1%) and 50 spontaneous losses (24.9%). In a comparison of the survivors and losses, there was no significant difference in mean corpus luteum size (1.9 versus 1.7 cm; P = .10, t test), mean resistive index (0.50 versus 0.50; P = .71, t test), peak systolic velocity (21 versus 19 cm/s; P = .29, t test), or sonographic appearance (P = .78, χ 2 test). The lack of association between corpus luteum characteristics and outcome persisted when cases were stratified by progesterone use and the presence or absence of a heartbeat on the study sonogram. Conclusion. There is no apparent relationship between the characteristics of the corpus luteum and first-trimester pregnancy outcome. Key words: pregnancy, sonography; ovary; corpus luteum; outcome, first trimester. he corpus luteum forms in the ovary after ovulation and has the critical role of progesterone production in early pregnancy. Resection of the corpus luteum before 7 to 8 weeks' menstrual age has been shown to result in pregnancy loss. Received December 19, 2000, from the Division of Ultrasound, Department of Radiology (M.C.F., P.M.D., S.M.D., D.N.D.S., F.C.L., D.L.B., C.B.B.), and1 With the advent of transvaginal gray scale and Doppler sonography, the corpus luteum can be evaluated noninvasively.Several recent studies have evaluated the sonographic and Doppler characteristics of the corpus luteum.2-9 In particular, the blood flow characteristics have been well defined. The corpus luteum is a very vascular structure, with peripheral flow easily identified on color Doppler sonography. This flow persists throughout the first trimester and is present in normal as well as abnormal gestations. 4,5,8 A higher resistive index (RI) has been reported in both anembryonic gestations and cases of fetal death compared with normal pregnancies. 6,7 In a

Doppler and biochemical assessment for the prediction of early pregnancy outcome in patients experiencing threatened spontaneous abortion

“…This finding was in disagreement with previous studies T A B L E 3 Biochemical markers and uterine artery resistance index represented as a percentage of the normal standard level at a given pregnancy duration. 15 The uterine artery Doppler indices were not significantly different between the groups in the present study. that assessed the embryonic heart rate very early in pregnancy (at 6 weeks) and found that a slow heart rate (less than 110 beats/min) was associated with fetal demise.…”

“…15 To eliminate inter-observer variability, the Doppler examinations were performed by a single sonographer (HAAA). After identifying the uterine artery waveform, at least three consecutive correctly imaged waveforms were assessed by pulsed Doppler.…”

Pelvic Imaging in Reproductive Endocrinology

“…365 Claims have been made that correlations exist between CL Doppler data and quality of the luteal phase, 366 leading to the proposal that Doppler data could be used for assessing the luteal phase 367 and predicting pregnancy outcome. 368 In spontaneously occurring singleton pregnancies, Frates and colleagues failed to find a correlation between the echographic characteristics of the CL and first trimester pregnancy outcome. 368 On gray-scale images, we believe that an educated eye can easily identify the fine dual contours of vessels that run around the CL, an impression which is supported by the finding of a correlation between Doppler data and vascular density.…”

“…368 In spontaneously occurring singleton pregnancies, Frates and colleagues failed to find a correlation between the echographic characteristics of the CL and first trimester pregnancy outcome. 368 On gray-scale images, we believe that an educated eye can easily identify the fine dual contours of vessels that run around the CL, an impression which is supported by the finding of a correlation between Doppler data and vascular density. 369 It should be noted that the increased vascularity of the CL may at times be confused with the vascular ring that characterizes certain ectopic pregnancies.…”

Akut Abdomen

“…Ayırıcı tanı geniş olup şüpheli durumlarda ektopik gebeliğin US ile dışlanması gerekir. US'de ön planda korpus luteumdan ayrılması gerekli olup korpus luteumun intraadneksal kist ya da kitle şeklinde görülmesi ayrımda önemlidir [22].…”