The assessment of the gestational sac diameter, crown–rump length, progesterone and fetal heart rate measurements at the 10th gestational week to predict the spontaneous abortion risk

Abstract

The assessment of the first trimester ultrasonographic and progesterone measurements to predict spontaneous abortion risk. Ninety-nine women at the 10th week of pregnancy were included in this prospective study. Their ages, progesterone (P) levels, mean gestational sac diameters (MGSD), crown-rump lengths (CRL), MGSD-CRL measurements and fetal heart rates (FHR) were recorded. These variables were compared by abortion status. Patients were followed up until the 20th weeks, and 8 (8.08%) aborted. We evaluated the variables by receiver operator characteristic curve to predict abortion. Only the areas under the curve for P levels (0.29) and for MGSD--CRL (0.16) were statistically significant We. also made logistic regression analysis to predict abortion. P level and FHR were statistically significant (P < 0.01) when the threshold value was 50%. Negative predictive value of the model was 98.9%, and positive predictive value was 50%. Overall, this model can correctly classify 94.9% of the groups. We determined threshold values for MGSD-CRL (> or =10 mm) and P (> or =25 ng/mL) to predict abortion, but not for FHR. Interestingly, 14 patients with FHR > or =175 beats/min did not abort. For the MGSD-CRL threshold, we can predict that the pregnancy will continue with 95.78% probability, with 67% sensitivity and 89% specificity. For the P threshold, the pregnancy will continue with 97.85% probability, with 80% sensitivity and 80% specificity. MGSD-CRL and P could predict patients with low abortion risk. However, at the 10th week of pregnancy, FHR > or =175 beats/min should be evaluated for this purpose by future studies with larger sample sizes.