Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome?

Tan, Sinan; Tangal, Nuray Gülden; Kanat-Pektaş, Mine; Özcan, Ayşenur Şirin; Keskin, Hüseyin Levent; Akgündüz, Gökçe; Teber, Mehmet Akif; Arslan, Halil

doi:10.11152/mu.2014.2066.161.st1gt2

Cited by 34 publications

(25 citation statements)

References 13 publications

(24 reference statements)

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“…19 Tan et al found that large YS correlated well with later risk of miscarriage, while irregular or echogenic YS appearance were unrelated to any increased risk of spontaneous miscarriage. 20 This agrees with the current results showing low rates of abnormal YS shape and echogenicity among cases with established missed miscarriage. The results of Cho et al also agreed with those of the current study that in cases of missed miscarriage with blighted ovum, the commonest YS abnormalities seen were absent or relatively large YS.…”

Section: Discussionsupporting

confidence: 94%

“…The most recurring associations were absent YS with GD1, normal-sized or small YS with normal-looking embryos, and cystic YS with isolated embryonic malformations. Future research may look into combining our findings with those of previous studies 19,20 for predicting the pregnancy outcome when such anomalies are seen during the first trimester. It may also include assessment of the final outcome of ongoing pregnancies following the detection of abnormal YS diameter, shape, or echogenicity.…”

supporting

confidence: 50%

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Relation between types of yolk sac abnormalities and early embryonic morphology in first‐trimester missed miscarriage

Ashoush

Abuelghar

Tamara

et al. 2015

J of Obstet and Gynaecol

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This study found a significant relation between YS abnormalities and embryonic morphology in missed miscarriage cases. This was most evident with abnormalities in YS diameter rather than the YS shape or appearance. The commonest combinations met in our cases were growth disorganized 1 embryos with an absent YS, normal embryonic morphology with normal or small YS, and isolated embryonic defects with cystic YS.

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Section: Discussionsupporting

confidence: 94%

supporting

confidence: 50%

Relation between types of yolk sac abnormalities and early embryonic morphology in first‐trimester missed miscarriage

Ashoush

Abuelghar

Tamara

et al. 2015

J of Obstet and Gynaecol

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“…Tan S et al in their study suggested that irregular yolk sac is not associated with increased risk of spontaneous abortion. 17 There was a gender variance seen in the present study related to the gender of the babies. Majority of the live borns having a small yolk sac were female.…”

Section: Discussionmentioning

confidence: 45%

Yolk sac and its effects on fetal prognosis

Das

Roy

2018

Int J Reprod Contracept Obstet Gynecol

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Background:The yolk sac is the first extra embryonic structure that becomes sonographically visible within the gestational sac. It provides nutritional, metabolic, endocrine, immunologic, and hematopoietic functions during organogenesis in embryonic life, before placental circulation is established. Spontaneous abortion rates are significantly elevated where the yolk sac volume falls outside the 5 th to 95 th percentile. Abnormal morphological appearance of the yolk sac is also suggestive of serious growth disorders of the fetus. The aim is to find out the predictive value of yolk sac on outcome of the pregnancy and any probable relationship of the yolk sac pattern with the gender of the fetus. Methods: The present study was carried out on fifty patients in their first trimester of pregnancy. Patients were divided into their respective gestational age groups and according to the morphology of the yolk sac. Data were compared using Chi square test. p value less than 0.5 was considered significant. Results: Out of the fifty patients, twenty-nine were having regular yolk sac, eleven were with irregular yolk sac and ten were with hyperechoic yolk sac. There was a significant number of fetal demise in the cases with hyperechoic and irregular yolk sac. Also, there were hardly any live births in the few cases in which the yolk sac was either too small or too big. Conclusions: The present study concludes that along with a yolk sac of a given normal range for its size, it should also be of normal morphology for better prognosis of the pregnancy. Also, the increase in the number of female live births needs further studies as to whether there is any abnormality in the Y chromosome causing morphologically abnormal yolk sac and subsequent fetal demise.

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“…Due to this high incidence, multiple studies have been performed investigating various markers which could possibly identify pregnancies destined to be lost. An enlarged YS, greater than 6 mm, has been associated with this devastating pregnancy outcome, while a misshapen YS has minimal prognostic value . However, the YS has always been evaluated cross‐sectionally with only one ultrasound per patient .…”

Section: Introductionmentioning

confidence: 99%

Pilot study establishing a nomogram of yolk sac growth during the first trimester of pregnancy

Detti

Roman

Goedecke

et al. 2019

J of Obstet and Gynaecol

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Aim: The yolk sac (YS) has been reported as a reliable predictor of adverse pregnancy outcomes, however, it has always been evaluated cross-sectionally with a single ultrasound per patient. We sought to validate the use of YS dimensions in serial ultrasounds throughout the first 10 weeks of singleton and multiple gestations.Methods: This was a prospective cohort study where YS diameters were serially obtained with 2D ultrasound in singleton and multiple gestations from 5 to 11 weeks. Nonparametric test were used for comparisons with P < 0.05 indicating significance. Results: One hundred ninety-three patients were included, 42 twins (3 monochorionic and 39 dichorionic), 2 triplets (monochorionic twins plus a singleton) and 148 singleton pregnancies (238 total fetuses). There was no difference in YS dimensions in singleton versus multiple pregnancies. Starting at 5 weeks' gestation, the YS increased 0.4 mm (95% CI 0.3-0.5 mm) per week until 10 weeks' gestation. Forty-five fetuses were lost in the first trimester. The risk of pregnancy loss was higher with a large YS until 8 weeks (P ≤ 0.001), while after 8 weeks it was higher with a small YS (P < 0.005). Conclusion: We established a nomogram of YS development during the first 10 weeks of pregnancy. The YS reliably detected pregnancies that ended in loss as early as 6 weeks' gestation. The YS was either smaller or larger than in ongoing pregnancies. While all pregnancies with large YS were lost within 10 weeks, those with smaller YS were lost beyond the first 10 weeks.

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Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome?

Cited by 34 publications

References 13 publications

Relation between types of yolk sac abnormalities and early embryonic morphology in first‐trimester missed miscarriage

Relation between types of yolk sac abnormalities and early embryonic morphology in first‐trimester missed miscarriage

Yolk sac and its effects on fetal prognosis

Pilot study establishing a nomogram of yolk sac growth during the first trimester of pregnancy

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