Pregnancy outcome after a first trimester sonogram demonstrating fetal cardiac activity. 1993

M C Frates, and C B Benson, and P M Doubilet
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.

We conducted a prospective study to assess pregnancy outcome after a first trimester sonogram demonstrating a singleton intrauterine gestation with fetal cardiac activity. In each of the 556 cases, data recorded included indication for the sonogram, results of the sonogram, and pregnancy outcome. Sonographic abnormalities were found more frequently in patients scanned because of symptoms (14.0%) than among patients scanned for routine indications (6.0%) (P < 0.05, chi-squared). Among 556 patients with known outcomes, the overall loss rate was 9.4%. A trend was seen toward a higher loss rate in patients with abnormal than normal sonograms (15.2% versus 8.8%). The loss rate after a normal scan was similar in symptomatic (10.6%) and asymptomatic patients (9.1%) and declined progressively with gestational age from 17.0% at 6 to 7.9 weeks to 4.3% at 12 to 13 weeks (P < 0.01, chi-squared). These results can be used to convey prognostic information to patients after a normal first trimester sonogram demonstrating fetal cardiac activity. The likelihood of a good pregnancy outcome can be stated as a function of gestational age, and a symptomatic patient can be reassured after a normal scan that her prognosis is similar to that of an asymptomatic patient with a normal sonogram.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D011256 Pregnancy Outcome Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO. Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D011261 Pregnancy Trimester, First The beginning third of a human PREGNANCY, from the first day of the last normal menstrual period (MENSTRUATION) through the completion of 14 weeks (98 days) of gestation. Early Placental Phase,Pregnancy, First Trimester,Trimester, First,Early Placental Phases,First Pregnancy Trimester,First Pregnancy Trimesters,First Trimester,First Trimester Pregnancies,First Trimester Pregnancy,First Trimesters,Phase, Early Placental,Phases, Early Placental,Placental Phase, Early,Placental Phases, Early,Pregnancies, First Trimester,Pregnancy Trimesters, First,Trimesters, First
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D005318 Fetal Heart The heart of the fetus of any viviparous animal. It refers to the heart in the postembryonic period and is differentiated from the embryonic heart (HEART/embryology) only on the basis of time. Fetal Hearts,Heart, Fetal,Hearts, Fetal
D005865 Gestational Age The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination. Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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