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Ultrasound Diagnosis of Spontaneous Miscarriage

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Spontaneous Abortion

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Abstract

Since neither the extent and duration of bleeding nor the presence or absence of lower abdominal pain in the first trimester are reliable indicators of pregnancy outcome (Stabile 1988), attention has turned to biophysical and biochemical means of evaluating early human pregnancy. This chapter will describe the role of biophysical tools such as transabdominal ultrasound (TAS), transvaginal ultrasound (TVS) and doppler ultrasound in answering the following questions: am I pregnant? is my pregnancy normal? when is my baby due? will I miscarry? is my baby normal?

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References

  • Adam AH, Robinson HP, Dunlop C (1979) A comparison of crown rump length measurements using a real time scanner in the antenatal clinic and a conventional B scanner. Br J Obstet Gynaecol 86:521–524

    Article  PubMed  CAS  Google Scholar 

  • Bernaschek G, Rudelstorfer R, Csaicsich P (1988) Vaginal sonography versus serum hCG in early detection of pregnancy. Am J Obstet Gynecol 158:608–612

    PubMed  CAS  Google Scholar 

  • Benacerraf BR (1988) Intrauterine growth retardation in the first trimester associated with triploidy. J Ultrasound Med 7:153–155

    PubMed  CAS  Google Scholar 

  • Bigrigg MQ, Read MD (1991) Management of women referred to early pregnancy assessment unit: care and cost effectiveness. Br Med J 302:577–579

    Article  CAS  Google Scholar 

  • Bradley WG, Fiske CE, Filly RA (1982) The double sac sign of early intrauterine pregnancy: use in exlcusion of ectopic pregnancy. Radiol 143:223–226

    CAS  Google Scholar 

  • Bree RL, Edwards M, Bohm-Velez M, Beyler S, Roberts J, Mendelson AB (1989) Transvaginal sonography in the evaluation of normal early pregnancy: correlation with hCG level. AJR 153:75–79

    PubMed  CAS  Google Scholar 

  • Bromley B, Harlow BL, Laboda LA, Benacerraf BR (1991) Small sac size in the first trimester: a predictor of poor fetal outcome. Radiol 178:375–377

    CAS  Google Scholar 

  • Cacciatore B, Tiitinen A, Stenman UH, Ylostalo P (1990) Normal early pregnancy: serum hCG levels and vaginal ultrasonography findings. Br J Obstet Gynaecol 97:899–903

    Article  PubMed  CAS  Google Scholar 

  • Cadkin AV, McAlpin RT (1984) Detection of fetal cardiac activity between 41 and 43 days of gestation. J Ultrasound Med 3:499–503

    PubMed  CAS  Google Scholar 

  • Chilcote WS, Asokan S (1977) Evaluation of first trimester pregnancy by ultrasound. Clin Obstet Gynecol 20:253–264

    Article  PubMed  CAS  Google Scholar 

  • Chow KK, Vengadasalam D (1986) The predictive value of routine ultrasound in the clinical measurement of early pregnancy wastage. 12th World Congress on Fertility and Sterility, Singapore (Abstract), p 624

    Google Scholar 

  • deCrespigny L (1988) Early diagnosis of pregnancy failure with transvaginal ultrasound. Am J Obstet Gynecol 159:408–409

    PubMed  Google Scholar 

  • den Ouden M, Cohen-Overbeek TE, Wladimiroff JW (1990) Uterine and fetal umbilical artery flow velocity waveforms in normal first trimester pregnancies. Br J Obstet Gynaecol 97:716–719

    Article  Google Scholar 

  • Deutinger J, Rudelstorfer R, Bernaschek G (1988) Vaginosonographic velicometry of both main uterine arteries by visual vessel recognition and pulsed doppler method during pregnancy. Am J Obstet Gynecol 159:1072–1076

    PubMed  CAS  Google Scholar 

  • Dickey RP, Olar TT, Curole DN, Taylor SN, Rye PH, Matulich EM (1990) The probability of multiple births when multiple gestational sacs or viable embryos are diagnosed at first trimester ultrasound. Hum Reprod 5:880–882

    PubMed  CAS  Google Scholar 

  • Evans J (1991) Fetal crown rump length values in the first trimester based upon ovulation timing using the luteenizing hormone surge. Br J Obstet Gynaecol 98:45–51

    Google Scholar 

  • Ferrazzi E, Brambati B, Lanzani A, Oldrini A, Stripparo L, Guerneri S, Makowski EL (1988) The yolk sac in early pregnancy failure. Am J Obstet Gynecol 158:137–142

    PubMed  CAS  Google Scholar 

  • Farquhar CM, Rae T, Thomas DC, Wadsworth J, Beard RW (1989) Doppler ultrasound in the non pregnant pelvis. J Ultrasound Med 8:451–457

    PubMed  CAS  Google Scholar 

  • Goldstein SR, Subramanyan BR, Raghavendra BN, Horii SC, Hilton S (1983) Subchorionic bleeding in threatened abortion. AJR 141:975–978

    PubMed  CAS  Google Scholar 

  • Green JJ, Hobbins JC (1988) Abdominal ultrasound examination of the first trimester fetus. Am J Obstet Gynecol 159:165–167

    PubMed  CAS  Google Scholar 

  • Grudzinskas JG, Chard T (1991) Endocrinology and metabolism in early pregnancy. In: Chapman M, Grudzinskas JG, Chard T (eds) The embryo. Normal and abnormal development and growth. Springer-Verlag, London, pp 195–207

    Google Scholar 

  • Harris RD, Vincent LM, Askin FB (1988) Yolk sac calcification: a sonographic finding associated with intrauterine embryonic demise in the first trimester. Radiol 166:109–110

    CAS  Google Scholar 

  • Hertz RH, Sokol RJ, Knoke JD, Rosen MG, Chik L, Hirsch VJ (1978) Clinical estimation of gestational age: rules for avoiding preterm delivery. Am J Obstet Gynecol 139:500–506

    Google Scholar 

  • Jaffe R, Warsoff SL (1991) Transvaginal colour doppler imaging in the assessment of uteroplacental blood flow in the normal first trimester pregnancy. Am J Obstet Gynecol 164:781–785

    PubMed  CAS  Google Scholar 

  • Jauniaux E, Jurkovic D, Campbell S (1991) In vivo investigations of the anatomy and the physiology of early human placental circulations. Ultrasound Obstet Gynaecol 1:435–445

    Article  CAS  Google Scholar 

  • Jones HW, Acosta AA, Andrews MC et al. (1983) What is pregnancy? A question for in vitro fertilization. Fertil Steril 40:728–733

    PubMed  Google Scholar 

  • Jouppila P (1983) Clinical consequences after ultrasonic diagnosis of intrauterine haematoma in threatened abortion. J Clin Ultrasound 13:107–111

    Article  Google Scholar 

  • Jurkovic D, Jauniaux E, Kurjak A, Hustin J, Campbell S, Nicolaides KH (1991) Transvaginal color doppler assessment of the uteroplacental circulation in early pregnancy. Obstet Gynecol 77:365–369

    PubMed  CAS  Google Scholar 

  • Jurkovic D, Bourne TH, Jauniaux E, Campbell S, Collins WP (1992) Transvaginal colour doppler study of blood flow in ectopic pregnancies. Am J Obstet Gynecol, In Press.

    Google Scholar 

  • Klopper A, Ahmed AG (1985) New applications for the assay of placental proteins. Placenta 6:173–184

    Article  PubMed  CAS  Google Scholar 

  • Laboda LA, Estroff JA, Benacerraf BR (1989) First trimester bradycardia: a sign of impending fetal loss. J Ultrasound Med 8:561–563

    PubMed  CAS  Google Scholar 

  • Lasser D, Vollebergh J, Peisner DB, Sharma S, Timor-Tritsch IE (1990) First trimester fetal biometry using high frequency transvaginal ultrasound. Abstract #1114 Proceedings 34th Annual Convention of the American Institute for Ultrasound in Medicine, JUM 9:S41

    Google Scholar 

  • Levi CS, Lyons EA, Lindsay DJ (1988) Early diagnosis of non viable pregnancy with endovaginal ultrasound. Radiol 167:383–385

    CAS  Google Scholar 

  • Levi CS, Lyons EA, Zheng XH, Lindsay DJ, Holt SC (1990) Endovaginal ultrasound demonstration of cardiac activity in embryos of less than 5 mm in crown rump length. Radiol 176:71–74

    CAS  Google Scholar 

  • MacGregor SN, Tamura RK, Sabbagha RE, Minogue JP, Gibson ME, Hoffman DI (1987) Underestimation of gestational age by conventional crown rump length dating curves. Obstet Gynecol 70:344–348

    PubMed  CAS  Google Scholar 

  • Mantoni M, Pedersen JF (1981) Intrauterine haematomata. An ultrasound study of threatened abortion. Br J Obstet Gynaecol 88:47–51

    Article  PubMed  CAS  Google Scholar 

  • Mantoni M, Pedersen JF (1982) Fetal growth delay in threatened abortion: an ultrasound study. Br J Obstet Gynaecol 89:525–527

    Article  PubMed  CAS  Google Scholar 

  • Mantoni M (1985) Ultrasound signs in threatened abortion and their prognostic significance. Obstet Gynecol 65:471–475

    PubMed  CAS  Google Scholar 

  • Matta W, Stabile I, Shaw B, Campbell S (1988) Doppler assessment of uterine blood flow changes in patients with fibroids receiving the LHRH agonist buserelin. Fertil Steril 49:1083–1085

    PubMed  CAS  Google Scholar 

  • Mayden KL, Confino E, Miller CE, Friberg J, Gleicher N (1986) Decreased gestational sac volumes in pregnancies induced by human menopausal gonadotrophin. Fertil Steril 45:879–882

    PubMed  CAS  Google Scholar 

  • McKensie WE, Holmes DS, Newton JR (1988) Spontaneous abortion rate in ultrasonographically viable pregnancies. Obstet Gynecol 71:81–83

    Google Scholar 

  • Meegdes BHLM, Ingenhoes R, Peeters LLH, Exalto N (1988) Early pregnancy wastage: relationship between chorionic vascularisation and embryonic development. Fertil Steril 49:216–219

    PubMed  CAS  Google Scholar 

  • Mehalek KE, Rosenberg J, Berkowitz GS, Chitkara U, Berkowitz RL (1989) Umbilical and uterine artery flow velocity waveforms: Effect of sampling site on doppler ratios. J Ultrasound Med 8:171–176

    PubMed  CAS  Google Scholar 

  • Moore KL (1982) The developing human: clinically oriented embryology, 3rd edn. WB Saunders, Philadelphia

    Google Scholar 

  • Nyberg D, Mack L, Benedetti T (1987) Placental abruption and placental hemorrhage. Correlation of sonographic findings with fetal outcome. Radiol 164:357–359

    CAS  Google Scholar 

  • Nyberg DA, Mack LA, Harvey D, Wang K (1988) Value of the yolk sac in evaluating early pregnancies. J Ultrasound Med 7:129–135

    PubMed  CAS  Google Scholar 

  • Pedersen JF, Molsted-Pedersen L, Mortensen HB (1984) Fetal growth delay and maternal haemoglobin Ale in early diabetic pregnancy. Obstet Gynecol 64:351–354

    PubMed  CAS  Google Scholar 

  • Pedersen JF, Mantoni M (1990) Large intrauterine haematomata in threatened miscarriage. Frequency and clinical consequences. Br J Obstet Gynaecol 97:75–77

    Article  PubMed  CAS  Google Scholar 

  • Pennell RG, Needleman L, Pajak T, Baltarowich O, Vilaro M, Goldbeg BB, Kurtz AB (1990) Prospective comparison of vaginal and abdominal sonography in normal early pregnancy. J Ultrasound Med 10:63–67

    Google Scholar 

  • Pijenborg R, Dixon G, Robertson WB, Brosens I (1980) Trophoblast invasion of human deciduas from 8 to 18 weeks of pregnancy. Placenta 1:3–19

    Article  Google Scholar 

  • Pirrone E, Monteagudo A, Timor Tritsch IE (1990) Does blighted ovum really exist? Abstract #1116 Proceedings 34th Annual Convention of the American Institute for Ultrasound in Medicine, JUM 9:S41

    Google Scholar 

  • Reece EA, Scioscia AL, Pinter E, Hobbins JC, Green J, Mahoney MJ, Naftolin F (1988) Prognostic significance of the human yolk sac assessed by ultrasonography. Am J Obstet Gynecol 159:1191–1194

    PubMed  CAS  Google Scholar 

  • Regan L, Braude PR, Trembath PL (1989) Influence of past reproductive performance on risk of spontaneous abortion. Br Med J 299:541–545

    Article  CAS  Google Scholar 

  • Rempen A (1990) Diagnosis of viability in early pregnancy with vaginal sonography. J Ultrasound Med 9:711–716

    PubMed  CAS  Google Scholar 

  • Robinson HP (1972) Sonar in the management of abortion. J Obstet Gynaecol Br Cwlth 79:90–94

    Article  CAS  Google Scholar 

  • Robinson HP, Shaw-Dunn J (1973) Fetal heart rates as determined by sonar in early pregnancy. J Obstet Gynaecol Br Cwlth 80:805–809

    Article  CAS  Google Scholar 

  • Robinson HP (1975a) Gestational sac volumes as determined by sonar in the first trimester of pregnancy. Br J Obstet Gynaecol 82:100–107

    Article  PubMed  CAS  Google Scholar 

  • Robinson HP (1975b) The diagnosis of early pregnancy failure by sonar. Br J Obstet Gynaecol 82:849–857

    Article  PubMed  CAS  Google Scholar 

  • Robinson HP, Fleming JE (1975) A critical evaluation of sonar crown rump length measurements. Br J Obstet Gynaecol 82:702–707

    Article  PubMed  CAS  Google Scholar 

  • Rosen GF, Silva PD, Patrizio P, Asch RH, Yee B (1990) Predicting pregnancy outcome by the observation of a gestational sac or of early fetal cardiac motion with transvaginal ultrasonography. Fertil Steril 54:260–265

    PubMed  CAS  Google Scholar 

  • Schaaps JP, Soyeur D (1989) Pulsed doppler on a vaginal probe: Necessity, convenience or luxury? J Ultrasound Med 8:315–320

    PubMed  CAS  Google Scholar 

  • Schats R, Jansen CAM Wladimiroff JW (1990a) Embryonic heart activity: appearance and development in early human pregnancy. Br J Obstet Gynaecol 97:989–994

    Article  PubMed  CAS  Google Scholar 

  • Schats R, Jansen CAM, Wladimiroff JW (1990b) Abnormal embryonic heart rate pattern in early pregnancy associated with Down’s syndrome. Hum Reprod 5:877–879

    PubMed  CAS  Google Scholar 

  • Schneider L, Bessis R, Simonnet T (1979) The frequency of ovular resorption during the first trimester of twin pregnancy. Acta Genet Med Gemellol 28:271–272

    PubMed  CAS  Google Scholar 

  • Shenker L, Astle C, Reed K (1986) Embryonic heart rates before the seventh week of pregnancy. J Reprod Med 31:333–336

    PubMed  CAS  Google Scholar 

  • Stabile I (1988) Pregnancy associated plasma protein A in complications of early pregnancy with particular reference to ectopic gestation. Ph.D. Thesis, University of London

    Google Scholar 

  • Stabile I (1991) Anembryonic pregnancy. In: Chapman M, Grudzinskas JG, Chard T (eds.) The embryo. Normal and abnormal development and growth. Springer-Verlag, London, pp 35–43

    Google Scholar 

  • Stabile I, Campbell S, Grudzinskas (1987) Ultrasonic assessment of complications during first trimester of pregnancy. Lancet ii: 1237–1240

    Google Scholar 

  • Stabile I, Bilardo C, Panella M, Campbell S, Grudzinskas JG (1988) Doppler measurement of uterine blood flow in the first trimester of normal and complicated pregnancies. Troph Res 3:301–307

    Google Scholar 

  • Stabile I, Campbell S, Grudzinskas (1989a) Ultrasound and circulating placental protein measurements in complications of early pregnancy. Br J Obstet Gynaecol 96:1182–1191

    Article  PubMed  CAS  Google Scholar 

  • Stabile I, Campbell S, Grudzinskas (1989b) Threatened miscarriage and intrauterine hematomas: Sonographic and biochemical studies. J Ultrasound Med 8:289–292

    PubMed  CAS  Google Scholar 

  • Stabile I, Olajide F, Chard T, Grudzinskas JG (1989c) Maternal serum alphafetoprotein levels in anembryonic pregnancy. Hum Reprod 4:204–205

    PubMed  CAS  Google Scholar 

  • Stabile I, Campbell S, Grudzinskas (1989d) Doppler assessed uteroplacental blood flow impedance in the first trimester: physiological variation with site of measurement. J Obstet Gynaecol 9:177–179

    Article  Google Scholar 

  • Stabile I, Campbell S, Grudzinskas (1990a) Doppler assessed uteroplacental blood flow in normal and failed first trimester pregnancy. In: Echocardiography: A review of cardiovascular ultrasound 6:353–356

    Google Scholar 

  • Stabile I, Grudzinskas JG, Campbell S (1990b) Doppler ultrasonographic evaluation of abnormal pregnancies in the first trimester. J Clin Ultrasound 18:497–501

    Article  PubMed  CAS  Google Scholar 

  • Steer CV, Campbell S, Pampiglione JS, Kingsland CR, Mason BA, Collins WP (1990) Transvaginal colour flow imaging of the uterine arteries during the ovarian and menstrual cycles. Hum Reprod 5:391–395

    PubMed  CAS  Google Scholar 

  • Taylor KJW, Ramos IM, Feyock AL, Snower DP, Carter D, Shapiro BS, Meyer WR, deCherney AH (1989) Ectopic pregnancy: duplex doppler evaluation. Radiol 173:93–97

    CAS  Google Scholar 

  • Thaler I, Manor D, Itskovitz J, Rottem S, Levit N, Timor-Tritsch IE, Brandes JM (1990) Changes in uterine blood flow during human pregnancy. Am J Obstet Gynecol 162:121–125

    PubMed  CAS  Google Scholar 

  • Timor Tritsch IE, Rottem S, Thaler I (1988) Review of transvaginal sonography: a description with clinical application. Ultrasound Quarterly 8:1–34

    Article  Google Scholar 

  • Varma TR (1981) The implication of a low implantation of the placenta detected by ultrasonography in early pregnancy. Acta Obstet Gynecol Scand 60:265–268

    Article  PubMed  CAS  Google Scholar 

  • Yeh HC, Goodman JD, Carr L, Rabinowitz JG (1986) Intradecidual sign: an ultrasound criterion of early intrauterine pregnancy. Radiol 161:463–467

    CAS  Google Scholar 

  • Ylostalo P, Ammala P, Seppala M (1984) Intrauterine haematoma and placental protein 5 in patients with uterine bleeding during pregnancy. Br J Obstet Gynaecol 91:353–356

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Isabel Stabile
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  2. S. C. Campbell
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Editor information

Editors and Affiliations

  1. Center for Biomedical Research and Toxicology, Florida State University, Tallahassee, Florida, 32303, USA

    Isabel Stabile PhD, MRCOG

  2. Academic Unit of Obstetrics and Gynaecology, The Royal London Hospital, Whitechapel, London, E1 1BB, UK

    Isabel Stabile PhD, MRCOG  & J. G. Grudzinskas MD, FRCOG, FRACOG  & 

  3. Academic Unit of Reproductive Physiology, St Bartholomew’s Hospital Medical College, London, EC1A 7BE, UK

    T. Chard MD, FRCOG

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© 1992 Springer-Verlag London Limited

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Stabile, I., Campbell, S.C. (1992). Ultrasound Diagnosis of Spontaneous Miscarriage. In: Stabile, I., Grudzinskas, J.G., Chard, T. (eds) Spontaneous Abortion. Springer, London. https://doi.org/10.1007/978-1-4471-1918-0_5

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  • DOI: https://doi.org/10.1007/978-1-4471-1918-0_5

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1920-3

  • Online ISBN: 978-1-4471-1918-0

  • eBook Packages: Springer Book Archive

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