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First-Trimester Ultrasound: Early Pregnancy Failure

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First-Trimester Ultrasound

Abstract

First-trimester pregnancy failure is defined by ultrasound as a lack of sonographic evidence of current or expected viability. Risk factors for pregnancy failure include: increasing maternal age, increased age at first menses, a low β-hCG or progesterone level, cigarette smoking, vaginal bleeding, and a history of prior pregnancy loss. Imaging clues such as an empty gestational sac ≥25 mm or an embryo ≥7 mm without cardiac activity are reliable signs of pregnancy failure. Less reliable signs include an irregular gestational sac, an abnormal or enlarged yolk sac, an empty amniotic sac, embryonic growth less than 1 mm per day, embryonic heart rate less than 85 beats per minute, a chorionic bump, and a subchorionic hematoma. A small gestational sac compared to the size of the embryo is suspicious for pregnancy failure especially when the size difference of the crown rump length to gestational sac size is less than 5 mm.

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Authors and Affiliations

  1. Division of Ultrasound, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, 15213, USA

    Timothy P. Canavan MD, MSc

  2. The Center for Advanced Fetal Diagnostics, Magee Women’s Hospital, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA, 15213, USA

    Timothy P. Canavan MD, MSc

  3. Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine, Texas Children’s Hospital – Pavilion for Women, 6651 Main Street, Suite F1020, Houston, TX, 77030-3498, USA

    Joan M. Mastrobattista MD

  4. Baylor College of Medicine, 1 Baylor Plaza, BCM 610, Houston, TX, 77030-3498, USA

    Joan M. Mastrobattista MD

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  1. Timothy P. Canavan MD, MSc
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Correspondence to Timothy P. Canavan MD, MSc .

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Editors and Affiliations

  1. Division of Maternal-Fetal Medicine Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA

    Jacques S. Abramowicz

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Canavan, T.P., Mastrobattista, J.M. (2016). First-Trimester Ultrasound: Early Pregnancy Failure. In: Abramowicz, J. (eds) First-Trimester Ultrasound. Springer, Cham. https://doi.org/10.1007/978-3-319-20203-7_15

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  • DOI: https://doi.org/10.1007/978-3-319-20203-7_15

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