Prediction of early pregnancy loss by transvaginal ultrasound and color doppler study

Abstract EN

Objectives : To use transvaginal ultrasound measuring parameters like gestational sac diameter (MSD), crown rumb length (CRL), fetal heart rate pattern (FHR), color Doppler study of uterine artery to predict the cases at risk of pregnancy loss during first trimester.

Design : Prospective study.

Setting : Al-Azhar University Hospitals (Sayed Galal and Al-Hussein Hospitals).

Patients : Two hundred patients during first trimester, classified into : 80 patients (control group) healthy women just coming for antenatal care, 60 patients had history of recurrent pregnancy loss and 60 patients complains from mild vaginal bleeding (Threatened abortion).

Intervention : Transvaginal ultrasound every two weeks to measure MSD, CRL and FHR pattern and uterine artery blood flow.

Results : The MSD was increased by an average 7.7mm each week while CRL increased by 3.4mm each week, lag of growth of MSD, CRL by one week predict the early pregnancy loss, also the resistance index (RI.) and pulsatility index (PI) of uterine artery decreasing with advancement of gestational age, failure of such decrease predict the cases at risk of pregnancy loss.

Conclusion : Transvaginal ultrasound measurement of MSD, CRL, FHR pattern, could be used as predictor of early pregnancy loss, Doppler U / S along is not a good predictor unless used in conjunction with other parameters like MSD, CRL, FHR pattern.