Endovaginal US: demonstration of cardiac activity in embryos of less than 5.0 mm in crown-rump length.

Levi, C S; Lyons, Edward A.; Zheng, X H; Lindsay, D J; Holt, Susan C.

doi:10.1148/radiology.176.1.2191372

Cited by 111 publications

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“…Our institution recently reported that in a series of 37 such embryos consecutively seen over a 4-year period in women who were threatening to abort, none subsequently had a normal obstetric delivery or development of embryonic cardiac activity (ECA) but instead were confirmed as early pregnancy failures. 7 Our results were similar to those of Levi et al 4 when their data were confined to women with vaginal bleeding.…”

supporting

confidence: 90%

“…This is because there are literature references to the sonographic detection of early embryos before the onset of cardiac contractility. [2][3][4][5][6] Therefore, it is possible that tiny embryos without visible heartbeats are actually alive, but their heart has simply not yet begun to beat. Thus, repeated sonograms are commonly recommended when tiny embryos without heartbeats are identified.…”

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confidence: 99%

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The Expanded Amnion Sign

Yegul

Filly

2009

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to assess the positive predictive value for confirming early embryonic death in the clinical scenario wherein an embryo is identified without a visible heartbeat, but the embryonic crown-rump length (CRL) is 5 mm or less. Methods. We conducted a retrospective study of 882 first-trimester sonograms with abnormal findings among women who were threatening to abort. Eight hundred six met the inclusion criteria. Results. Among the cohort of 806 cases, 520 (64.5%) had an identifiable embryo, and 255 of those with an identifiable embryo had a visible amnion (49.0%). One hundred sixteen of the 255 with a visible amnion and an identifiable embryo without a heartbeat had a CRL that measured 5 mm or less (45.5%). The CRL of these embryos ranged from 1.7 to 5.4 mm (ie, when rounded to the nearest millimeter, these embryos would be 5 mm) with the breakdown as follows: those measuring less than or equal to 3.4 mm (n = 28), those measuring 3.5 to 4.4 mm (n = 45), and those measuring 4.5 to 5.4 mm (n = 43). Eight of these 116 patients did not have any documented follow-up. In the remaining 108 patients, pregnancy failure was confirmed. Conclusions. We conclude that any embryo that is surrounded by an amnion and that also lacks a heartbeat has unfortunately but definitively died. This is equally true for embryos measuring less than 5 mm in CRL.

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confidence: 90%

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confidence: 99%

The Expanded Amnion Sign

Yegul

Filly

2009

Journal of Ultrasound in Medicine

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“…39,40 It is expected that an embryonic heart rate may be documented by the time when the CRL is at greater than 4 to 5 mm. 25,41 The embryonic heart rate also has some predictive value in determining pregnancy outcome. The embryonic heart rate at first appearance may be slow but may increase progressively until 9 weeks gestation and then decrease until the end of the first trimester.…”

Section: Diagnosing Pregnancy Failurementioning

confidence: 99%

Evaluation of Early Pregnancy Failure with Ultrasound

Burlingame¹

2007

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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“…The sensitivity and specificity with regard to failed early pregnancy of various ultrasound findings that have been suggested to be diagnostic of non-viability are shown in Table 2 [10][11][12][13][14][15]. The sensitivity and specificity will depend on the skill of the ultrasound examiner, the quality of the ultrasound equipment and any presence of technical problems, e.g., large uterine fibromas obscuring the view of the uterine cavity.…”

Section: Bleeding And/or Pain In Early Pregnancymentioning

confidence: 99%

Imaging in gynecology

Valentin

2006

Best Practice & Research Clinical Obstetrics & Gynaecol

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This chapter summarizes the diagnostic performance (sensitivity, specificity, positive and negative likelihood ratios) of ultrasound, computer tomography, and magnetic resonance imaging in the diagnosis of various gynecological diseases and tumors. Positron emission tomography is not discussed. Imaging in infertility, in the diagnosis of Mullerian duct anomalies and in gynecological oncology (staging of gynecological cancers, diagnosis of recurrence of gynecological cancer, diagnosis of trophoblastic tumors) is not dealt with.Ultrasound is the first line imaging method for discrimination between viable intrauterine pregnancy, miscarriage and tubal pregnancy in women with bleeding and/or pain in early pregnancy, for discrimination between benign and malignant adnexal masses and for making a specific diagnosis in adnexal tumors (e.g., dermoid cyst, endometrioma, hemaorrhagic corpus luteum, ectetera), for diagnosing intracavitary uterine pathology in women with bleeding problems, and for confirming or refuting pelvic pathology in women with pelvic pain. Magnetic resonance imaging may have a role as a secondary test in the diagnosis of adenomyosis, 'deep endometriosis' (e.g., endometriosis in the rectovaginal septum or in the utero-sacral ligaments), and in the diagnosis of extremely rare types of ectopic pregnancy (e.g., in the spleen, liver or retroperitoneum).

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Endovaginal US: demonstration of cardiac activity in embryos of less than 5.0 mm in crown-rump length.

Cited by 111 publications

References 0 publications

The Expanded Amnion Sign

The Expanded Amnion Sign

Evaluation of Early Pregnancy Failure with Ultrasound

Imaging in gynecology

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