Early sonographic markers and prediction of pregnancy outcome: a prospective study

Jaishree Bamniya, Divyesh Panchal, Pooja Singh, Ami Shah, Harshad Ladola



Background: The objective of the study was to examines the pregnancy outcome in patients with early sonography markers and study design was a prospective study.

Methods: This prospective study was conducted at Department of Obstetrics and Gynaecology, GCS Medical College, Ahmedabad, Gujarat, India from Feb 2012 to August 2016. Total of 612 Women with early pregnancy were included in the study that fulfilled the inclusion criterias. After first sonography examination patients were assigned to the control group and study group. Patients were followed up for outcome.14 pateients were lost to follow up.

Results: The incidence of pregnancy loss was highest with Large yolk sac i.e 78.57%, followed by loss with Bradycardia (38%), Tachycardia (15.78%) and Smaller than normal G Sac to be 14.28%. As compared to control which had pregnancy loss of only 7.7%. Incidence of other complications like IUGR, PIH were also increased in patients with abnormal early sonography markers up to 33%.

Conclusions: T Transvaginal sonography should be used adequately to look for early pregnancy markers like Size of Gestational sac, size and shape of yolk sac, fetal heart rate and in cases of threatened abortion presence of subchorionic haematoma and its size because all these markers are good predictors of pragnacy outcome and can prove helpful in patient counseling.


Bradycardia, Gestational sac, IUGR, TVS, Yolk sac

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Wilcox AJ, Weinberg CR, O’Connor JF. Incidence of early pregnancy loss. N Engl J Med. 1988;319:189-94.

Lindsay DJ, Lovett IS, Lyons EA. Yolk sac diameter and shape at endovaginal US: predictors of pregnancy outcome in the first trimester. Radiology. 1992;183:115-8.

Tan S, Pektaş MK, Arslan H. Sonographic Evaluation of the Yolk Sac. JIUM. 2012;31(1)87-95.

Hornberger LK, Sahn DJ. Rhythm abnormalities of the fetus. Heart. 2007;93(10):1294-300.

Varelas FK, Prapas NM, Liang RI, Prapas IM, Makedos GA. Yolk sac size and embryonic heart rate as prognostic factors of first trimester pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2008;138:10-3.

Mackenzie WE, Holmes DS, Newton JR. Spontaneous abortion rate in ultrasonographically viable pregnancies. Obstet Gynecol. 1988;71:81-3.

Stefos TI, Lolis DE, Sotiriadis AJ, Ziakas GV. Embryonic heart rate in early pregnancy. J Clin Ultrasound. 1998;26:33-6.

Hyett J, Moscoso G, Nicolaides K. Abnormalities of the heart and great arteries in first trimester chromosomally abnormal fetuses. Am J Med Genet. 1997;69:207-16.

Elson J, Salim R, Tailor A, Banerjee S, Zosmer N, Jukovic D. Prediction of early pregnancy viability in the absence of an ultrasonically detectable embryo. Ultrasound Obstet Gynecol. 2003;21:57-61.

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

Nyberg DA, Laing FC, Filly RA. Threatened abortion: sonographic distinction of normal and abnormal gestation sacs. Radiology. 1986;158:397-400.

Ball RH. The sonography of pregnancy loss. Semin Reprod Med. 2000;18:351-5.

Cunningham FG, Gant NF, Leveno KJ, Gilstrap LC III, Health JC, Wenstrom KD. 21st ed. Williams obstetrics. New York: McGraw-Hill; 2001:866-67.

Fotios K Varelas, Nicolaos M. Prapas, Ren-Ing Liang Loannis M. Prapas Georgios A. Makedos. Yolk sac size and embryonic heart rate as prognostic factors of first trimester pregnancy outcome. European J Obstetr Gynecol Reproduct Biol. 2008;138(1):10-3.

Nagy S, Bush M, Stone J, Lapinski RH, Gardo’S. Clinical significance of subchorionic and retroplacental hematomas detected in the first trimester of pregnancy. Obstet Gynecol. 2003;102(1):94-100.