Résumé
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