Triple ultrasound markers including fetal cardiac activity are related to miscarriage risk

Bae, Soyoung; Karnitis, Joseph V.

doi:10.1016/j.fertnstert.2011.08.009

Cited by 21 publications

(16 citation statements)

References 34 publications

(39 reference statements)

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“…Despite the fact that there is no clearly identified consensus, an enlarged yolk sac can be depicted as a yolk sac with a diameter of 5 or 6 mm. Generally, it has been suggested that an abnormally large yolk sac indicates poor obstetric outcome [4,6,7]. A recent study has shown that a yolk sac diameter of greater than 5 mm is associated with an increased risk of spontaneous abortion [6].…”

Section: Perinatal Mortalitymentioning

confidence: 99%

“…The diameter of a yolk sac is usually 3-4 mm and increases in size up to the 10 th or 11 th week of gestation [3]. It has been hypothesized that abnormal sonographic findings related to the size, shape and internal structure of a yolk sac can be used to predict gestational outcome [3][4][5][6][7]. It has been well established that an abnormally large yolk sac correlates with early pregnancy failure [4,6,7].…”

Section: Introductionmentioning

confidence: 99%

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Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome?

et al. 2014

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Aims: The present study aimed to determine whether yolk sacs with abnormal sonographic appearance are associated with adverse perinatal outcomes in both early and late gestation. Matherial and methods: A total of 305 viable singleton pregnancies with gestational age of 6 to 9 weeks were prospectively evaluated with respect to perinatal outcomes and sonographic characteristics of the yolk sacs. Results: An abnormal yolk sac was found in 66 pregnancies. In pregnancies with enlarged yolk sacs a miscarriage occurred in 37.5% of cases (3/8). The pregnancies with a yolk sac diameter ≥ 5 mm had a significantly higher risk of miscarriage (p = 0.005). The risk of miscarriage was statistically similar between the pregnancies with regular and those with irregular yolk sacs (p = 0.73). Miscarriage occurred in 3.8% of pregnancies with irregular yolk sacs (2/52) and none of pregnancies with echogenic yolk sacs (0/6). Adverse perinatal outcomes were not associated with either irregular or echogenic yolk sacs. Conclusions: An enlarged yolk sac visualized before the 7th week of gestation is strongly associated with a significantly increased risk for spontaneous miscarriage. The presence of an echogenic or irregular yolk sac appears to be unrelated to adverse perinatal outcome.

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Section: Perinatal Mortalitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome?

et al. 2014

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“…An excessively large or small yolk sac, as well as the absence of a yolk sac, is associated with adverse pregnancy outcomes [ 7 , 8 ]. The ongoing pregnancy rate was much greater in the group in which the yolk sac diameter (YSD) ranged from 2 to 6 mm than that in groups in which the YSD was either less than 2 mm or greater than 6 mm (OR = 33.1, P < 0.001) [ 9 ]. The mean gestational sac diameter (MSD) and crown-rump length (CRL) are also predictors of EPL [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

A logistic model to predict early pregnancy loss following in vitro fertilization based on 2601 infertility patients

Ouyang

et al. 2016

Reprod Biol Endocrinol

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BackgroundAccording to previous studies, even after embryonic cardiac activity is detected, the pregnancy loss rate remains 3–4 %. The objectives of this study were to investigate the differences in ultrasound parameters between a miscarriage group and an ongoing pregnancy group during the 1st trimester and to build a logistic model to predict early pregnancy loss (EPL) after the appearance of embryonic cardiac activity in patients who have undergone in vitro fertilization embryo transfer (IVF-ET) treatment.MethodA total of 2601 patients with early singleton pregnancies with embryonic cardiac activity were retrospectively analyzed after IVF from January 2010 to June 2011. Transvaginal sonography (TVS) was performed at 6 to 10 weeks of gestational age (GA). The mean gestational sac diameter (MSD), crown-rump length (CRL), fetal heart rate (FHR), and yolk sac diameter (YSD) were measured by TVS.ResultsA total of 2400 patients had an ongoing pregnancy and an additional 201 (7.7 %) patients miscarried during the first trimester after fetal cardiac activity had been established. The maternal age (MA) and infertility duration were much greater, and the MSD, CRL, and FHR were much lower in the miscarriage group than in the ongoing pregnancy group after IVF (P < 0.05). The prediction model utilized the following equation: the possibility of EPL = exp(z)/(1 + exp(z)), where z = −21.456 + (0.114 × MA) + (4.305 × × GA) - (0.043 × MSD) - (0.359 × CRL) - (0.091 × FHR) + 2.243 (fluid collection present around the gestational sac (GS)) + 2.519 (when YSD < 3) or - 0.347 (when YSD > 5.5).ConclusionThe MA, MSD, CRL, YSD, FHR, infertility duration, and fluid collection around the GS were each correlated with EPL after IVF in infertile patients. A logistic model is a useful tool for predicting EPL after the appearance of embryonic cardiac activity (area under the curve [AUC] = 0.909).

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“…11 In summary, caution must be used in interpreting ultrasound results given the small but possible likelihood that pregnancies with abnormal ultrasound findings may be viable. A retrospective review of more than 1000 women who had TVS between postconception days 33 and 36 reported an ongoing pregnancy rate of approximately 94% if the following 3 markers were identified: gestational sac diameter more than 12 mm, yolk sac size 2 to 6 mm, and fetal cardiac activity present.…”

Section: Accuracy Of Ultrasound In Assessing Risk Of Embryonic Demisementioning

confidence: 99%

Evaluation and Management of First-Trimester Bleeding

Matthews¹

2012

Postgraduate Obstetrics & Gynecology

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Learning Objectives: After participating in this CME activity, the obstetrician/gynecologist should be better able to: 1. Identify the risk factors and common etiologies for first-trimester bleeding. 2. Compare normal and abnormal ultrasound findings in the first trimester and their association with pregnancy loss. Analyze outcomes for pregnancies with first-trimester bleeding and counsel patients regarding the risk of subsequent pregnancy complications. 4. Evaluate the management options for treatment of nonviable pregnancies.Lippincott Continuing Medical Education Institute, Inc., is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Lippincott Continuing Medical Education Institute, Inc., designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.To earn CME credit, you must read the CME article and complete the quiz and evaluation on the enclosed answer form, answering at least seven of the 10 quiz questions correctly.

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Triple ultrasound markers including fetal cardiac activity are related to miscarriage risk

Cited by 21 publications

References 34 publications

Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome?

Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome?

A logistic model to predict early pregnancy loss following in vitro fertilization based on 2601 infertility patients

Evaluation and Management of First-Trimester Bleeding

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