First-trimester Sonography Research Articles

First-trimester US parameters of failed pregnancy.

To test the reliability of established ultrasound (US) parameters in predicting the outcome of first-trimester pregnancy. 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. 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. 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.

Prognosis of first-trimester twin pregnancies: polychotomous logistic regression analysis.

To determine which clinical and sonographic characteristics independently affect the prognosis of first-trimester twin pregnancies and to develop formulas for calculating the probabilities of the pregnancy resulting in two, one, or no liveborn infants. The authors prospectively identified 137 twin pregnancies with two heartbeats at first-trimester sonography and with known pregnancy outcome. Stepwise polychotomous logistic regression analysis was used to identify characteristics that have an independent statistically significant relationship with pregnancy outcome and to develop outcome-prediction formulas. Of 137 patients, 110 (80.3%) had viable twins, 12 (8.8%) had one infant, and 15 (10.9%) had none. Gestational age, chorionicity, and sonographic findings were independent, statistically significant (P < .05) prognostic factors, while maternal age, method of conception, and indication for sonography were not. The logistic regression formulas involving the three independent prognostic factors can be used in the first trimester to predict pregnancy outcome.

First-trimester ultrasonography findings in women with a history of recurrent pregnancy loss

We tabulated first-trimester ultrasonography findings in women with recurrent pregnancy loss and determined the rate of subsequent pregnancy loss and live births after demonstration of a live embryo. Sixty-seven women with three or more recurrent miscarriages underwent first-trimester ultrasonography and were prospectively followed through 101 pregnancies. First-trimester ultrasonography showed a dead embryo in seven pregnancies. Two of gestational sac in 12, and an empty uterus in four. A live embryo was seen in 78 pregnancies. Two of these pregnancies were terminated because of fetal chromosomal abnormalities. Of the remaining 76 pregnancies, 13 (17%) ended in a fetal loss (spontaneous abortion or fetal death) and 63 (83%) resulted in viable live births. Among women with recurrent pregnancy loss the presence of a live embryo detected by first-trimester ultrasonography is not as encouraging as in normal pregnant women. These findings are useful in counseling patients with recurrent pregnancy loss.

Adverse effect of an overdistended bladder on first-trimester sonography.

Adverse effect of an overdistended bladder on first-trimester sonographyME Baker, BS Mahony and JD BowieAudio Available | Share