Ultrasonographic characteristics in patients clinically diagnosed with threatened abortion.

OBJECTIVE: To determine ultrasonographic appearances in pregnant women clinically diagnosed with threatened abortion. DESIGN: Cross-sectional study. MATERIAL AND METHOD: Seven hundred and seventy six pregnant women clinically diagnosed with threatened abortion and receiving ultrasonographic examination were enrolled Data on ultrasonographic characteristics were obtained from records at the Maternal-fetal Medicine unit. Pregnancy outcomes were reviewed from medical records. RESULTS: The ultrasonographic findings demonstrated 328 (42.3%) viable pregnancy, 178 (22.9%) embryonic death, 176 (22.7%) anembryonic pregnancy, 25 (3.2%) incomplete abortion, 24 (3.1%) complete abortion, seven (0.9%) molar pregnancy, four (0.5%) ectopic pregnancy, and 34 (4.4%) inconclusive finding. Two hundred and sixty viable pregnancies were available for follow-up and revealed that 229 (88.1%) eventually delivered while 31 (11.9%) ended up with abortion. The two groups were not significantly different regarding age, parity, history of abortion, and gestational age at diagnosis. CONCLUSION: Ultrasonographic findings in patients clinically diagnosed with threatened abortion demonstrated viable pregnancy in nearly half of the cases. Transvaginal ultrasonography is useful in establishing definite diagnosis and appropriate treatment among these patients.

Sonographic findings in clinically diagnosed threatened abortion.

OBJECTIVE: To determine the sonographic appearances in pregnant women who presented with vaginal bleeding in the first 20 weeks of gestation. METHOD: Pregnant women of under 20 gestational weeks diagnosed clinically as threatened abortion were recruited for ultrasound scan at the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University. The sonographic findings were reported as viable pregnancy, anembryonic pregnancy, embryonic death, incomplete abortion, complete abortion, ectopic pregnancy, molar pregnancy and inconclusive findings. Patients with inconclusive findings were followed weekly until final diagnoses were established. All patients were followed-up to 20 weeks or until the final outcomes were revealed. RESULTS: Two hundred and sixty eight pregnant patients were enrolled. Ultrasound scans demonstrated 100 viable fetuses (37.3%), 73 embryonic deaths (27.3%), 46 anembryonic pregnancies (17.2%), 6 molar pregnancies (2.2%), 3 ectopic pregnancies (1.1%), 14 complete abortions (5.2%) and 26 inconclusive findings (9.7%). Follow-up scan on patients with inconclusive findings revealed 9 anembryonic pregnancies (3.3%), 9 incomplete abortions (3.3%), 1 embryonic death (0.4%) and 1 viable pregnancy (0.4%). Six patients (2.3%) were lost to follow-up. The viable pregnancy rate according to maternal age was highest at the maternal age of 25 to 29 years old (49%), whereas, it was lowest at the maternal age of 40 to 44 years old (0%). The viable pregnancy rate according to gestational age was highest at 6 to 8 weeks (61.2%), whereas, it was lowest at 18 to 20 weeks (20%). CONCLUSION: Sonographic findings in patients with clinically diagnosed threatened abortion demonstrated viable pregnancies in around one-third of the cases. Use of ultrasound in clinically diagnosed threatened abortion may assist clinicians in establishing a definite diagnosis so that appropriate care could be offered to the patients.

Ultrasonographic demonstration of fetal cardiac activity in threatened abortion and its prognostic significance

To evaluate the prognostic value of detecting fetal heart activity in cases of threatened abortion occurring early in the first trimester, and consequently to demonstrate the importance of ultrasonography in the routine management of vaginal bleeding in early pregnancy. Two hundred and sixteen patients were enrolled in this study. They were all seen in the first attack of vaginal bleeding, occurring in the first trimester. Fetal cardiac activity was demonstrated by the use of abdominal ultrasound on the first visit. They all had singleton pregnancy. There was neither history of recurrent abortion, nor intake of anticoagulant drugs. The patients were then seen weekly or whenever bleeding recurred. No drugs were given. Out of the 216 cases, 193 [89.4%] continued to full-term delivery. Twenty three cases [10.6%] aborted during the first or second trimester. Premature delivery, congenital abnormalities and cesarean section rates were not significantly different from the expected averages of the general population. Eighteen of these 23 cases of fetal loss started bleeding in the late weeks of the first trimester [10th - 12th week]. At the first attack of vaginal bleeding occurring in the first trimester, if the cervix is closed and a living fetus could be demonstrated, the pregnancy should be considered viable and the outlook for fetal survival is favorable. Sonographic demonstration of fetal cardiac activity is assuring, indicating a low risk of subsequent abortion and a favorable prognosis