Abstract
Introduction:
This study aimed to evaluate clinical and ultrasonographic markers associated with spontaneous miscarriage in viable first-trimester intrauterine pregnancies.
Methods:
A prospective cross-sectional study was conducted between May 2021 and May 2024 involving viable singleton pregnancies (5 + 4 to 10 + 6 weeks of gestation) that underwent transvaginal ultrasound. The ultrasound markers evaluated were gestational sac, yolk sac, fetus, mean gestational sac diameter (MSD), crown-rump length (CRL), subchorionic heamatoma, corpus luteum, fetal heart rate, and basal decidua. Clinical variables included vaginal bleeding, nausea and/or vomiting, and breast pain.
Results:
The sample consisted of 258 patients, of whom 215 (83.3%) progressed to term pregnancy and 43 (16.7%) experienced miscarriage. Women with a fetal heart rate < 5th percentile for gestational age had a miscarriage rate of 33.3%. Women with an MSD minus CRL ⩽ 5 mm had a higher percentage of miscarriage (80.0%) compared to those with an MSD minus CRL > 5 mm (15.4%). An MSD minus CRL ⩽ 5 mm and fetal heart rate < 5th percentile were associated with 21.3-fold and 2.8-fold increased risks of miscarriage, respectively. The Hosmer–Lemeshow test indicated good model fit (p = 0.804). No clinical variables or other ultrasound markers were significantly associated with miscarriage.
Conclusion:
Fetal heart rate and MSD minus CRL were the only first-trimester ultrasonographic markers significantly associated with spontaneous miscarriage.
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