scholarly journals Predictors of poor first trimester outcome in asymptomatic women : the value of embryonic heart rate , mid sac diameter / yolk sac ratio & mid sac diameter / crown rump length

2019 ◽  
Vol 13 (2) ◽  
pp. 46-50
Author(s):  
Suaad Abdulkadhim
Keyword(s):  
Heart Rate ◽  
First Trimester ◽  
Embryonic Heart ◽  
Yolk Sac ◽  
Successful Outcome ◽  
Transvaginal Sonography ◽  
Cross Sectional ◽  
Crown Rump Length ◽  
Poor Outcome ◽  
Asymptomatic Women

Background:  Ultrasound provides a powerful tool for assessing early pregnancy and detecting pregnancy failure at first trimester and promoting rapid effective management. Several  criteria have been established  to predict  the pregnancy outcome particularly in symptomatic women . Aim: To evaluate  asymptomatic women at the first trimester of pregnancy , to assess the efficacy of certain ratios as mid sac diameter (MSD)  / yolk sac ratio & crown rump length (CRL)/mid sac diameter (as indicator  of early first trimester oligohydramnios)  in predicting poor 1st   trimester outcome Type of the study: A cross-sectional study. Patients & Methods:  A sixty three asymptomatic women were enrolled in this prospective study . Transvaginal sonography was performed for confirmation of pregnancy viability & exclusion of multiple pregnancies 6-8 weeks of gestation & follow up ultrasound repeated at the beginning of second trimester to confirm the continuation of pregnancy and  viability of fetus. Several parameters assessed and tested against each others as embryonic heart rate , the size and morphologic criteria of gestational sac , yolk sac and  the crown rump length  Results: The women  were classified into two groups: group A are those with successful outcome at the first trimester and group B are those with poor outcome of the 1st trimester . Decrease embryonic heart rate below 100 beat per minute  and low mid sac diameter/ yolk sac size ratio of < 1.9 , were found to be significant predictors of poor outcome however mid sac diameter/crown rump length ratio was not found to  have a similar significance  Conclusion: In addition to the classical parameters  assessed  by trans-vaginal ultrasound, other important parameters need to be routinely applied as the  embryonic heart rate that predict poor outcome when less than 100 bpm . In addition to the ratio of mid sac diameter to the yolk sac diameter which  , if less than 1.9 ,  may point to abnormal  first trimester fate.

scholarly journals EMBRYONIC HEART RATE: A PROGNOSTIC FACTOR OF FIRST TRIMESTER PREGNANCY OUTCOME

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Chetana Choudhary ◽  
Lata Rajoria ◽  
Chelsae Kuntal ◽  
Sunita Hemani ◽  
Aditi Bansal ◽  
...  
Keyword(s):  
Heart Rate ◽  
Gestational Age ◽  
Pregnancy Loss ◽  
Cardiac Activity ◽  
First Trimester ◽  
Good Prognosis ◽  
Embryonic Heart ◽  
Transvaginal Sonography ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy

Introduction: The earliest proof of a viable pregnancy is obtained when cardiac activity of the embryo can be observed. Transvaginal sonography can accurately demonstrate embryonic heart rate at 6 weeks of gestational age by using M-mode transvaginal sonography. Slow embryonic heart rate at 6-7 weeks of gestational age is associated with high rate of first trimester pregnancy loss. AIM:  The study was aimed to evaluate the role of embryonic heart rate (EHR) of early pregnancies as predictive factor of adverse outcome at end of first trimester of pregnancy. Methods: This observational study was conducted in the Department of Obstetrics and Gynecology Zenana Hospital, SMS Medical College, Jaipur. It included 300 pregnant women between 6 weeks to 9 weeks of gestational age attending antenatal OPD. Embryonic heart rate was measured by transvaginal sonography. Embryonic heart rate was classified as slow, if it was fewer than 110 beats/ mint or outcome was measured as occurance of spontaneous pregnancy loss prior to 12 weeks. Results: Out of 300 cases, 290 (96.67%) had embryonic heart rate ?100 beats per minutes and 10(3.33%) had embryonic heart rate <100 beats per minutes. Out of these 290, (Embryonic heart rate ?100 beats per minutes), 284 (97.93%) had good prognosis and 6 (2.07%) had abortion. In 10 women (Embryonic heart rate <100 beats per minutes), 3 (30.00%) had good prognosis and 7 (70.00%) had abortion. This observation was statistically significant. Conclusion: Slow embryonic heart rate on ultrasonography reduced the success of pregnancy and may lead to abortion. Keywords: Embryonic heart rate, Ultrasonography, Early pregnancy loss

scholarly journals The pattern of variations in the first trimester fetal heart rate in Indian population: a pilot study

2019 ◽  
Vol 8 (11) ◽  
pp. 4419
Author(s):  
Hethyshi R.
Keyword(s):  
Heart Rate ◽  
Gestational Age ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
First Trimester ◽  
Embryonic Heart ◽  
Large Sample Size ◽  
Crown Rump Length ◽  
Heart Rates ◽  
South Indian

Background: Fetal heart rate is an indicator of fetal viability. During third trimester and labour the normal range of fetal heart rate is between 110-160 bpm as recommended by the international guidelines. Unlike this, the first trimester embryonic heart rate does not lie in the same range. During the first trimester the normal embryonic heart rate varies between each week of gestation, as determined by a few western studies. Indian studies on the same are not available. Objective of this study was to determine the trend of the fetal heart rate in first trimester of pregnancy in South Indian women.Methods: Transvaginal scan was done in 51 pregnant women with singleton pregnancy attending the antenatal clinic in a medical college hospital. Crown rump length and fetal heart rate were measured and plotted on a graph. Also, the fetal heart rate at different gestational age of our study was compared with the fetal heart rates at the same gestational age from the studies in the western population.Results: The range of fetal heart rate at different weeks of gestation was comparable to the heart rate variations as seen in the western population. The maximum heart rates at 9 weeks of gestation in our study was higher than the heart rate in the western population.Conclusions: Possibility of variation in the fetal heart rates in the first trimester in different populations cannot be ruled out until confirmed by studies with large sample size.

scholarly journals Effect of abnormal yolk sac, gestational sac and embryonic heart rate in pregnancy outcome

2021 ◽  
Author(s):  
Jyoti Jaiswal ◽  
Anand Kumar Jaiswal ◽  
Geetanjali Patel ◽  
Abha Daharwal
Keyword(s):  
Heart Rate ◽  
Pregnancy Outcome ◽  
Predictive Value ◽  
Tertiary Care ◽  
Embryonic Heart ◽  
Yolk Sac ◽  
Transvaginal Sonography ◽  
Tertiary Care Centre ◽  
Singleton Pregnancy ◽  
Gestational Sac

Background: The purpose of the study is to know the effect of abnormal yolk sac, abnormal gestational sac and abnormal embryonic heart rate on outcome of pregnancy in the tertiary care centre of Chhattisgarh.Methods: This prospective observational study included 50 pregnant females between 6-9 weeks gestation with singleton pregnancy attending antenatal clinic in a tertiary medical institution. Transvaginal sonography was carried out to quantify yolk sac characteristics. Abnormal yolk sac was defined according to Nyberg criteria.Results: Out of 50 cases, 25 cases had abnormal yolk sac, 23 cases had abnormal gestational sac and 22 cases had abnormal embryonic heart rate and heart rate was absent in 23 cases. Out of 50 cases, 32 got aborted and rest 18 cases had ongoing pregnancy beyond 20 weeks. Normal yolk sac diameter (YSD) (2-5 mm) showed 72.2% sensitivity, 62.5% specificity, 52% positive predictive value and 80% negative predictive value in predicting pregnancy outcome. Gestational sac diameter had 66.66% sensitivity, 53.12% specificity, 44.44% PPV and 73.91% NPV and for EHR had 22.22% sensitivity, 96.87% specificity, 80% PPV and 68.88% NPV.Conclusions: The embryos with abnormal YSD are highly associated with poor pregnancy outcome with good sensitivity and NPV. Present study indicates that the yolk sac measurement is reliable prognostic factor in predicting 1st trimester pregnancy outcome.

STUDY OF PRENATAL DEVELOPMENTAL EVENTS IN FIRST TRIMESTER OF PREGNANCY IN KHYBER PAKHTUN KHUWA: AN ULTRASONIC STUDY

JKCD ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 15-18
Author(s):  
Munila Shabnum Khattak
Keyword(s):  
Gestational Age ◽  
Growth Parameters ◽  
Abdominal Ultrasound ◽  
First Trimester ◽  
Yolk Sac ◽  
Cross Sectional ◽  
Crown Rump Length ◽  
Developmental Anatomy ◽  
First Trimester Of Pregnancy ◽  
Gestational Sac

Objective: To study the prenatal developmental anatomy in first trimester of pregnancy in Khyber Pakhtun Khuwa. Materials and methods: The cross sectional study was conducted on 600 pregnant females visiting the antenatal clinic of Khyber Teaching Hospital Peshawar and Khyber clinic (Jamrud). The duration of study was 6 months. A pregnant women greater than 16 years of age, willing for ultrasound was selected, poor visualization due to technical factors like obesity, surgical scar were excluded. All the patients were enlisted under informed consent. Detailed obstetrical history was taken. The embryos were visualized with the help of abdominal ultrasound. Data were recorded followed by statistical analysis and presented as percentages. Results: In the present study, 591 cases (98.5%) were single, 8 (1.33%) cases were twin and one case is (0.16%) of triplets. The distributions of normal and abnormal cases were studied in first trimester. The shape of gestational sac was regular in 370(61.66%) and irregular in 230(38.33%) Yolk sacs were identified in 430(71.6%) cases, while in 170(28.33%) of cases yolk sac could not be identified. It could not be identified in 50 (8.33%) of cases due to early pregnancy and in 120 (20%) of cases due to abnormal pregnancy. The Fetal pole was detected in 150(25%) cases and could not be identified in 450 (75%) of cases. The relationship of gestational age, gestational sac and crown rump length in normal pregnancy was observed. Conclusions: There is linear increase in measurements of fetal growth parameters as the gestational age increases. For the assessment of gestational age in the first trimester, ultrasound is an accurate and useful modality. Key words: Trimester, Gestational sac, Yolk sac and Crown rump length.

Yolk sac size and embryonic heart rate as prognostic factors of first trimester pregnancy outcome

2008 ◽  
Vol 138 (1) ◽  
pp. 10-13 ◽  
Author(s):  
Fotios K. Varelas ◽  
Nicolaos M. Prapas ◽  
Ren-Ing Liang ◽  
Ioannis M. Prapas ◽  
Georgios A. Makedos
Keyword(s):  
Heart Rate ◽  
Prognostic Factors ◽  
Pregnancy Outcome ◽  
First Trimester ◽  
Embryonic Heart ◽  
Yolk Sac ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy

scholarly journals Evaluation of yolk sac size and embryonic heart rate in first trimester and pregnancy outcome

2021 ◽  
Vol 10 (8) ◽  
pp. 2975
Author(s):  
Waleed M. Tawfik
Keyword(s):  
Heart Rate ◽  
Pregnancy Outcome ◽  
First Trimester ◽  
Group Iv ◽  
Embryonic Heart ◽  
Yolk Sac ◽  
First Trimester Pregnancy ◽  
Trimester Pregnancy ◽  
Group I ◽  
Significant Difference

Background: Accurate differentiation between normal pregnancy and pregnancy loss in early gestation remains a clinical challenge-previous studies have described the association between embryonic well-beings and the characteristics of gestational sac. The aim of the study was to evaluate the yolk sac size and embryonic heart rate as a prognostic factor for the first trimester pregnancy outcome.Methods: This was a prospective cohort observesional study. It included 52 pregnant women in their first trimester from 6 week till 12 weeks gestation. Transvaginal sonographic examination after explanation and agreement of each patient. All pregnancies were followed for their pregnancy outcome after completion of 12 weeks. The adverse outcome was spontaneous miscarriage occurring before or at 12 weeks of gestation. These patients allocated into four study groups: according to gestational age at presentation and pregnancy outcome. Group I included women who were examined during (6-7 weeks+6 days). Group II included women who were examined during (8-9 weeks+6 days). Group III included women who were examined during (10-12 weeks). Group IV included women who had their pregnancies resulted into first trimester spontaneous miscarriage.Results: The validity of YS diameter regarding the prognosis of first trimester pregnancy outcome shows that; YSD had 100% specificity and 97.8% sensitivity in prediction of miscarriage. Regarding embryonic heartbeat, there was a statistically significant difference between group IV and the other groups. There was embryonic bradycardia in the miscarriage group. EHR had a sensitivity of 97.5% and specificity of 100% in prediction of first trimester pregnancy outcome.Conclusions: Abnormal yolk sac diameter, in the form of small, enlarged, absent or irregular yolk sac, and embryonic bradycardia are associated with poor pregnancy outcome.

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