<scp>OC</scp>19.06: The psychological effects and patient acceptability of a test to predict viability in early pregnancy: a prospective randomised study

Davison, A. Z.; Sana, Y.; Johns, Jemma; Ross, Jackie

doi:10.1002/uog.13587

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…3 The ability to effectively predict the possibility of miscarriage or ongoing pregnancy beyond the first trimester has the potential to lower anxiety level irrespective of the pregnancy outcome. 4 Among women undergoing in vitro fertilization (IVF)/embryo transfer (ET), a routine blood or urine sample is obtained at 4 weeks' gestation to confirm if pregnancy has occurred and a clinical pregnancy is confirmed by ultrasound at 6 weeks' gestation. A number of ultrasound markers have been demonstrated to be potential predictors for early miscarriage, such as fetal crownrump length (CRL), 5 mean gestational sac diameter (mGSD), 6 and mean uterine artery pulsatility index (mUTPI), 7 while the predictive value of these markers varies in different studies.…”

Section: Introductionmentioning

confidence: 99%

“…significantly lower the anxiety level irrespective of the pregnancy outcome 4. The ability to effectively predict the possibility of miscarriage or ongoing pregnancy among women who have undergone IVF/ET might facilitate antenatal counseling and management in clinical practice, allowing close monitoring in targeted high-risk women and further investigation of potential therapeutic interventions for the prevention of miscarriage among pregnancies following IVF/ET.…”

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confidence: 99%

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Biomarkers at 6 weeks' gestation in the prediction of early miscarriage in pregnancy following assisted reproductive technology

Guo

Feng

Chaemsaithong

et al. 2023

Acta Obstet Gynecol Scand

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Introduction Miscarriage is a major concern in early pregnancy among women having conceived with assisted reproductive treatments. This study aimed to examine potential miscarriage‐related biophysical and biochemical markers at 6 weeks' gestation among women with confirmed clinical pregnancy following in vitro fertilization (IVF)/embryo transfer (ET) and evaluate the performance of a model combining maternal factors, biophysical and biochemical markers at 6 weeks' gestation in the prediction of first trimester miscarriage among singleton pregnancies following IVF/ET. Material and methods A prospective cohort study was conducted in a teaching hospital between December 2017 and January 2020 including women who conceived through IVF/ET. Maternal mean arterial pressure, ultrasound markers including mean gestational sac diameter, fetal heart activity, crown rump length and mean uterine artery pulsatility index (mUTPI) and biochemical biomarkers including maternal serum soluble fms‐like tyrosine kinase‐1 (sFlt‐1), placental growth factor (PlGF), kisspeptin and glycodelin‐A were measured at 6 weeks' gestation. Logistic regression analysis was carried out to determine significant predictors of miscarriage prior to 13 weeks' gestation and performance of screening was estimated by receiver‐operating characteristics curve analysis. Results Among 169 included pregnancies, 145 (85.8%) pregnancies progressed to beyond 13 weeks' gestation and had live births whereas 24 (14.2%) pregnancies resulted in a miscarriage during the first trimester. In the miscarriage group, compared to the live birth group, maternal age, body mass index, and mean arterial pressure were significantly increased; mean gestational sac diameter, crown rump length, mUTPI, serum sFlt‐1, glycodelin‐A, and the rate of positive fetal heart activity were significantly decreased, while no significant differences were detected in PlGF and kisspeptin. Significant prediction for miscarriage before 13 weeks' gestation was provided by maternal age, fetal heart activity, mUTPI, and serum glycodelin‐A. The combination of maternal age, ultrasound (fetal heart activity and mUTPI), and biochemical (glycodelin‐A) markers achieved the highest area under the curve (AUC: 0.918, 95% CI 0.866–0.955), with estimated detection rates of 54.2% and 70.8% for miscarriage before 13 weeks' gestation, at fixed false positive rates of 5% and 10%, respectively. Conclusions A combination of maternal age, fetal heart activity, mUTPI, and serum glycodelin‐A at 6 weeks' gestation could effectively identify IVF/ET pregnancies at risk of first trimester miscarriage.

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Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

Biomarkers at 6 weeks' gestation in the prediction of early miscarriage in pregnancy following assisted reproductive technology

Guo

Feng

Chaemsaithong

et al. 2023

Acta Obstet Gynecol Scand

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“…Yet, studies have shown that women with uncertain pregnancy diagnoses experience unique anxiety that is improved with increased diagnostic certainty, regardless of eventual outcome. 8,9 There are also medical risks associated with delayed diagnosis, essentially forcing expectant management of miscarriage, as opposed to medical or surgical management. Each week of expectant management is associated with a 25-30% chance of spontaneous passage of pregnancy tissue, 10 which entails heavy bleeding and sometimes severe cramping.…”

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confidence: 99%

The Burden of Abortion Restrictions and Conservative Diagnostic Guidelines on Patient-Centered Care for Early Pregnancy Loss

Judge-Golden

Flink-Bochacki

2021

Obstetrics &Amp; Gynecology

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Intrauterine pregnancies of uncertain viability are common, and guidelines for diagnosing early pregnancy loss must balance the risk of interrupting a viable pregnancy with the anxiety and medical complications resulting from delayed diagnosis. Two cases of likely early pregnancy loss presenting as intrauterine pregnancies of uncertain viability are described, with stark differences in care availability related to state reproductive health care regulations. Onerous abortion restrictions, medical and societal stigma, and inherent pronatalism in diagnostic criteria interfere with the exercise of clinical judgment and can damage patients' physical or mental health.

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OC19.06: The psychological effects and patient acceptability of a test to predict viability in early pregnancy: a prospective randomised study

Cited by 2 publications

References 9 publications

Biomarkers at 6 weeks' gestation in the prediction of early miscarriage in pregnancy following assisted reproductive technology

Biomarkers at 6 weeks' gestation in the prediction of early miscarriage in pregnancy following assisted reproductive technology

The Burden of Abortion Restrictions and Conservative Diagnostic Guidelines on Patient-Centered Care for Early Pregnancy Loss

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