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Pilot study establishing a nomogram of yolk sac growth during the first trimester of pregnancy
Author(s) -
Detti Laura,
Roman Robert A.,
Goedecke Patricia J.,
Christiansen Mary E.,
PeregrinAlvarez Irene,
Ikwuezunma Gini,
Francillon Ludwig
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14173
Subject(s) - medicine , gestation , singleton , nomogram , obstetrics , pregnancy , fetus , yolk sac , prospective cohort study , gestational age , gynecology , surgery , embryo , genetics , biology , microbiology and biotechnology
Aim The yolk sac (YS) has been reported as a reliable predictor of adverse pregnancy outcomes, however, it has always been evaluated cross‐sectionally with a single ultrasound per patient. We sought to validate the use of YS dimensions in serial ultrasounds throughout the first 10 weeks of singleton and multiple gestations. Methods This was a prospective cohort study where YS diameters were serially obtained with 2D ultrasound in singleton and multiple gestations from 5 to 11 weeks. Nonparametric test were used for comparisons with P < 0.05 indicating significance. Results One hundred ninety‐three patients were included, 42 twins (3 monochorionic and 39 dichorionic), 2 triplets (monochorionic twins plus a singleton) and 148 singleton pregnancies (238 total fetuses). There was no difference in YS dimensions in singleton versus multiple pregnancies. Starting at 5 weeks' gestation, the YS increased 0.4 mm (95% CI 0.3–0.5 mm) per week until 10 weeks' gestation. Forty‐five fetuses were lost in the first trimester. The risk of pregnancy loss was higher with a large YS until 8 weeks ( P ≤ 0.001), while after 8 weeks it was higher with a small YS ( P < 0.005). Conclusion We established a nomogram of YS development during the first 10 weeks of pregnancy. The YS reliably detected pregnancies that ended in loss as early as 6 weeks' gestation. The YS was either smaller or larger than in ongoing pregnancies. While all pregnancies with large YS were lost within 10 weeks, those with smaller YS were lost beyond the first 10 weeks.