The role of ultrasonographic markers for prediction of first trimester pregnancy outcomes

Objectives

Examining certain ultrasonographic parameters during the first trimester of pregnancy and determining their role to predict first trimester outcome. 

Methods 

It’s a prospective cohort study including 210 pregnant women that admitted to Ankara Etlik Zübeyde Hanım Women’s Health Training and Research Hospital Antenatal Care Unit. Patients’ gestational age were calculated according to last menstrual period. Embryonic heart rate and Yolk sac diameter were evaluated ultrasonographically during first 12 weeks of pregnancy and then patients who have lost their conceptus were confronted with non-aborted ones at the end of 12 weeks of pregnancy. Mono-directional variance analysis was used to determine the correlation between Yolk sac diameter and menstrual age, also between embryonic heart rate and menstrual age. (Menstrual Age) minus
(Mean Sac Diameter related Age)’, ‘Yolk Sac Diameter/Mean Sac Diameter ratio’, ‘(Mean Sac Diameter) minus (Crown-Rump Length)’ were compared between ‘the group of first trimester aborted’ and ‘the group of first trimester non-aborted’ with Independent T- Test. Regression analysis was performed for parameters, suitable graphs and curves were
drawn. Fisher Exact Test was performed to determine the decisiveness of ‘Embrional Heart Rate<120/minute’ and ‘(Menstrual Age) minus (Mean Sac Diameter related Age)’ values.

 Results 

Yolk sac diameter was decisive to predict abortion except 6-8 weeks of first trimester pregnancy (p<=0.001). Yolk sac diameters were increasing as gestational sac diameter and CRL (Crown-Rump Length) increased. Embryonic heart rate (lesser than 120 pulse per minute) was substantially decisive to predict abortion in all groups (p<0.001). The difference between ‘Menstrual Age’ and ‘Mean Sac Diameter related Age’ was substantially different between groups of aborted and non-aborted in the first trimester of pregnancy (p=0.024).

Conclusion 

Embryonic heart rate had a progressive rise in women that brought to completion of a healthy first trimester. Embryonic bradycardia can be used as a prognostic factor to predict adverse pregnancy outcomes. Yolk sac diameter and absence of yolk sac parameters needs further investigations. As the difference between ‘Menstrual Age’ and ‘Mean Sac Diameter related Age’ increased, the abortion risk also increased. Further investigations should be performed to make a flat decision.

Keywords

Marker, first trimester, embryonic heart rate