Open AccessRole of First Trimester Ultrasonographic Parameters for Prediction of Early Pregnancy Failure - A Prospective Observational Study from Punjab, India
Author(s) -
Amandeep Singh,
Avepreet Singh,
Kamal Kumar Gupta,
Gauravdeep Singh
Publication year - 2021
Publication title -
journal of evidence based medicine and healthcare
Language(s) - English
Resource type - Journals
eISSN - 2349-2570
pISSN - 2349-2562
DOI - 10.18410/jebmh/2021/93
Subject(s) - medicine , pregnancy , gestational sac , obstetrics , gestation , gestational age , miscarriage , prospective cohort study , fetus , observational study , gynecology , surgery , genetics , biology
BACKGROUND Early pregnancy failure is stated as noncompatible, intrauterine pregnancy with either an empty gestational sac or a gestational sac that contains an embryo or fetus which does not have any fetal cardiac activity in the initial 12 weeks of the pregnancy. In the assessment of early pregnancy, ultrasound plays a significant role. METHODS A prospective observational study was conducted in a tertiary care hospital between May 2019 and April 2020 among 500 pregnant females fulfilling the inclusion and exclusion criteria. Patient follow up was done by weekly telephonic calls until completing 12 weeks gestation or reporting miscarriage. Also, all patients were followed by the recommended routine ultrasound (US) scanning with or without emergency visits. RESULTS In our study period, 500 women fulfilling the inclusion criteria were included in our study. Out of whom, 85 (17.5 %) women had an early pregnancy failure (before 12 weeks). There was significantly lower mean gestational sac diameter (GSD), crown to rump length (CRL), fetal heart rate (FHR), and P-value < 0.001 in women who experienced early pregnancy failure. In pregnancies where the GSD, CRL, and FHR were below the 5th percentile, early pregnancy failure was a more prone outcome. All pregnancies with FHR below 75 beats per minute ended in failure in the present study. When FHR was less than 128 beats per minute, there was enormous rise in the frequency of pregnancy failure. By comparison, yolk sac diameter (YSD) was a less significant predictor of early pregnancy failure. CONCLUSIONS First-trimester ultrasonographic estimations help in predicting early abortion. Risk appraisal tables dependent on combinations of abnormal parameters could significantly help in identifying abnormal pregnancy from normal pregnancy and could improve prediction rates. KEYWORDS Early Pregnancy Failure, Prediction, Transvaginal Ultrasonography, Ultrasonography