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Radiology, Vol 203, 211-217, Copyright © 1997 by Radiological Society of North America

ARTICLES

First-trimester US parameters of failed pregnancy

SE Rowling, BG Coleman, JE Langer, PH Arger, HL Nisenbaum and SC Horii
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104, USA.

PURPOSE: To test the reliability of established ultrasound (US) parameters in predicting the outcome of first-trimester pregnancy. MATERIALS AND METHODS: The authors retrospectively reviewed 2,655 first- trimester US scans in 2,285 patients. Parameters tested against outcome were (a) a yolk sac and mean gestational sac diameter of 8 mm on transvaginal US scans, (b) an embryo and mean sac diameter of 16 mm on transvaginal US scans, and (c) a difference between the mean sac diameter and crown-rump length of less than 5 mm (oligohydramnios) at 5.5-9.0 weeks gestation. RESULTS: Thirty (22%) of 135 patients without yolk sacs and with an 8-mm mean sac diameter developed live embryos: 24 had normal follow-up or delivery; six were lost to follow-up. Five (8%) of 59 patients with no depiction of embryos and with a 16-mm mean sac diameter developed live embryos: Two delivered, one spontaneously aborted, one had death of one twin embryo before being lost to follow- up, and one was lost to follow-up. Seventeen (0.74%) of 2,285 patients had early oligohydramnios: Six (35%) had normal follow-up scans or delivery, two (12%) spontaneously aborted, and nine (53%) were lost to follow-up. CONCLUSION: Established parameters predictive of early pregnancy failure potentially result in misdiagnosis of nonviability or poor prognosis when applied to a large, unselected patient population. Close follow-up is necessary in cases with borderline abnormal findings.


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[Abstract] [Full Text] [PDF]


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