Journal of Diagnostics Concepts & Practice >
Prediction value of first trimester ultrasound parameters for pregnancy outcome
Received date: 2021-05-25
Online published: 2022-06-28
Objective: To explore the predictive value of ultrasonographic parameters in the first trimester pregnancy outcomes. Methods: A total of 1 651 pregnancy were enrolled, and ultrasonographic parameters including fetal heart rate(FHR), mean gestation sac diameter(MSD) and crown to rump length (CRL) at or before 7 weeks′ gestational age were measured, and the sonogram obtained at or before 13 weeks′ gestation to determine the embryo survived or demise.It revealed that 1 556 cases were classified into ongoing pregnancy group and 95 cases were into spontaneous abortion group. Results: Before 13 weeks′, the spontaneous abortion rate was 5.85% in the study. Pregnancy loss occurred in all the cases with the FHR slower than or equal to 80 bpm (100%), while in fetal with FHR>90 bpm decreased significantly (2.51%). The survival rate increased with the increase of FHR when FHR≤130 bpm, while the fetal demise rate increased as FHR>130 bpm(2.79%). The spontaneous abortion rate was 57.14% as MSD-CRL≤5 mm. The bigger the MSD-CRL was, the higher the survival rate was. Receiver operating characteristic (ROC) curve analysis demonstrated that AUC of FHR=97 bpm for poor pregnancy outcome was 0.870 (P<0.05), while sensitivity, specificity, PPV and NPV were 81.05%, 99.04%, 83.7% and 98.8% respectively. When MSD-CRL was taken as 11.3 mm, AUC for prediction of spontaneous abortion was 0.780(P<0.05), with sensitivity, specificity, PPV and NPV values were 56.84%, 89.01%, 24.00% and 97.10% respectively. When the combination of FHR and MSD-CRL, the AUC for prediction of spontaneous abortion was 0.922(P<0.05). Conclusions: The spontaneous abortion rate was 5.85% in the study. The cut-off value for FHR and MSD-CRL to predict abortion are 94 bpm and of 11.3 mm, respectively. The lower the fetal heart rate and the smaller MSD-CRL diameter are, the higher the spontaneous abortion rate will occur.
CAO Yunyun, WANG Guanjie, ZENG Min, WANG Haifeng, NIU Jianmei, ZHOU Leiping . Prediction value of first trimester ultrasound parameters for pregnancy outcome[J]. Journal of Diagnostics Concepts & Practice, 2021 , 20(05) : 445 -449 . DOI: 10.16150/j.1671-2870.2021.05.004
[1] | Abdallah Y, Daemen A, Kirk E, et al. Limitations of current definitions of miscarriage using mean gestational sac diameter and crown-rump length measurements: a multicenter observational study[J]. Ultrasound Obstet Gynecol, 2011,38(5):497-502. |
[2] | Wang XH, Wang HJ, Deng XH, et al. Predictive value of ultrasound-related scoring system on embryo development in early pregnancy after IVF/ICSI: An observation of embryonic quality[J]. Taiwan J Obstet Gynecol, 2019,58(4):501-504. |
[3] | Köşüş N, Köşüş A, Turhan NO. First trimester volumetric measurements: relation with hormone levels and fetal heart rate[J]. Arch Gynecol Obstet, 2012,286(2):365-372. |
[4] | Detti L, Francillon L, Christiansen ME, et al. Early pregnancy ultrasound measurements and prediction of first trimester pregnancy loss: A logistic model[J]. Sci Rep, 2020,10(1):1545. |
[5] | Datta MR, Raut A. Efficacy of first-trimester ultrasound parameters for prediction of early spontaneous abortion[J]. Int J Gynaecol Obstet, 2017,138(3):325-330. |
[6] | 严英榴, 杨秀雄. 产前超声诊断学[M]. 北京: 人民卫生出版社, 2012:46-48. |
[7] | Doubilet PM, Benson CB, Bourne T, et al. Diagnostic criteria for nonviable pregnancy early in the first trimester[J]. Ultrasound Q, 2014,30(1):3-9. |
[8] | Acharya G, Gui Y, Cnota W, et al. Human embryonic cardiovascular function[J]. Acta Obstet Gynecol Scand, 2016,95(6):621-628. |
[9] | Arleo EK, Troiano RN. Outcome of early first-trimester pregnancies (<6.1 weeks) with slow embryonic heart rate[J]. AJR Am J Roentgenol, 2011,197(1):252-255. |
[10] | 龚晓萍, 王冠杰, 王海飞, 等. 超声监测早孕期胚胎心率对妊娠结局的预测价值[J]. 中华超声影像学杂志, 2018,27(11):982-985. |
[11] | Kapfhamer JD, Palaniappan S, Summers K, et al. Diffe-rence between mean gestational sac diameter and crown-rump length as a marker of first-trimester pregnancy loss after in vitro fertilization[J]. Fertil Steril, 2018,109(1):130-136. |
[12] | 王冠杰, 王海飞, 龚晓萍, 等. 超声监测早孕期胎心率变化规律的初步研究[J]. 临床超声医学杂志, 2020,22(2):139-141. |
/
〈 |
|
〉 |