Predictive value of color flow Doppler ultrasound, maternal serum progesterone and beta subunit of human chorionic gonadotrophins in the outcome of first trimester threatened miscarriage

Abstract EN

Introduction: Miscarriage is the termination of pregnancy by any means before the fetus is sufficiently developed to survive.

More than 80 % of abortions occur in the first 12 weeks of pregnancy, and this rate decreases rapidly thereafter, Threatened miscarriage is the commonest complication of pregnancy, occurring in 15–20% of ongoing pregnancies (Cunningham et al., 2005).

Ultrasonographic features of early Pregnancy Loss are Size-Dates Discrepancy, decreased Trophoblastic thickness, Subchorionic Hematomas, Fetal heart bradycardia, abnormal Doppler study of uterine artery and Corpus Luteum of pregnancy (Sawyer et al., 2007).

Subjects & Methods: A prospective study was designed at Al-Azhar University Hospital on 100 pregnant women with first trimester threatened miscarriage and 50 normal pregnancy as a control Subsequently divided into continuing & non- continuing groups.

All cases were subjected to Transvaginal ultrasonound to assessment of gestational sac, fetal heart activity, early fetal bradycardia, subchorionic hematomas, discrepancy between gestational age using crown - rump length, trophoblastic thickness and Color Doppler for uteroplacental circulation & corpus luteum blood flow.

Single measurement of serum progesterone and beta subunit of human chorionic gonadotrophin was taken.

Results: The comparative study between patients and control groups regarding right & the left uterine arteries RI, & the mean value of corpus luteum RI showed no significant difference.

There was also no significant difference between the mean value of RI of the right & the left uterine arteries in the control & in patient’s groups.

There was no statistically significant difference between threatened continuing and non-continuing groups regarding the mean value of right and left uterine arteries resistive index or the mean value of Corpus luteum (RI).

Effect of Subchorionic hematoma on pregnancy outcome were analyzed according to the percentage of spontaneous abortion among cases with or without subchorionic hematoma, and also the relation between the site of subchorionic hematoma and the occurrence of spontaneous abortion all was statistically non-significant