Threatened abortion: sonographic distinction of normal and abnormal gestation sacs.

Nyberg, D A; Laing, F C; Filly, Roy A.

doi:10.1148/radiology.158.2.3510445

Cited by 109 publications

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“…9 Previous sonographic studies also suggest that a yolk sac is normally visualized before a living embryo. 10 -u Despite these observations, however, the yolk sac has not been specifically evaluated as evidence for an IUP before demonstration of an embryo. As we believed that identification of a yolk sac might be useful for confirming the presence of an IUP in women with suspected ectopic pregnancies and in whom a living embryo was not identified, this prospective study was performed.…”

mentioning

confidence: 99%

Value of the yolk sac in evaluating early pregnancies.

Nyberg

Mack

Harvey

et al. 1988

Journal of Ultrasound in Medicine

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To determine the potential value in identifying a yolk sac in women with suspected ectopic pregnancies, 211 consecutive women who were referred to pelvic sonography with this clinical indication were prospectively studied. Of the 211 patients examined, 104 proved to have a normal intrauterine pregnancy (IUP), 59 had an abnormal (nonviable) IUP, and 48 had a surgically‐proven ectopic pregnancy. Considering only intrauterine "sacs" that lacked a visible embryo, a yolk sack was identified in 16 of 26 (62%) normal IUPs, and 3 of 19 (16%) abnormal IUPs, but was not seen in any of six pseudo‐gestational sacs in women with ectopic pregnancies. In comparison, a double decidual sac (DDS) finding was thought to be present in 24 of 26 (92%) normal gestational sacs, 12 of 19 (63%) abnormal gestational sacs, and 2 of 6 (33%) pseudogestational sacs. We conclude that in women in whom a living embryo is not identified, demonstration of a yolk sac is reliable evidence for early IUP, and virtually excludes the possibility of an ectopic gestation. Although a yolk sac is less frequently observed than a DDS finding, it is also more specific evidence for an IUP. Careful attention to the yolk sac should permit earlier, more reliable diagnoses of IUP than previously possible.

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mentioning

confidence: 99%

Value of the yolk sac in evaluating early pregnancies.

Nyberg

Mack

Harvey

et al. 1988

Journal of Ultrasound in Medicine

Self Cite

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show abstract

“…21 However, because a yolk sac may not be present all the time prior to when a normal embryo is identified, YS identification alone is not a reliable single indicator of pregnancy viability. 22,23 The size of a yolk sac has also been associated with pregnancy outcome. There is a 60% positive predictive value of abnormal pregnancy outcome when the YS is greater than 2 standard deviations above the mean sac diameter.…”

Section: Location Of Pregnancymentioning

confidence: 99%

“…If one major criteria or three minor criteria were present, there was a 100% predictive value for abnormal pregnancy outcome. 23 With the large degree of variability in MSD cut-offs, MSD is not a good single predictor of pregnancy viability, and instead MSD should usually be used in combination with other findings or in serial ultrasound examinations. 23,35,36 The documentation of an embryo and its appropriate interval growth with development of a heart pulsation is a positive predictor of pregnancy success.…”

Section: Diagnosing Pregnancy Failurementioning

confidence: 99%

“…In fact, once an embryonic heart rate is documented by sonography, the miscarriage rate decreases to as low as 10%. 23,37,38 The embryonic heart rate can first be seen by TVS at 36 to 40 days gestation (menstrual age) when the heart tube is just forming (Fig. 4).…”

Section: Diagnosing Pregnancy Failurementioning

confidence: 99%

“…Gestational sac morphology, embryonic heart rate and yolk sac morphology all have some value in predicting chromosomal abnormalities. 23,45,46 There is, however, contradictory evidence regarding the predictive value of these findings and caution should be used in counseling the patient about genetic testing. 25,47 Given the ability to manage most miscarriages without any medical intervention, it is usually safe for the patient to wait for repeat studies while the certainty of the diagnosis is being made.…”

Section: Diagnosing Pregnancy Failurementioning

confidence: 99%

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The developmental origins of placental function

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The placenta is the link between mother and fetus and its function is central to a successful pregnancy. The predominant theory within the literature is that the development of placental dysfunction is a result of abnormal trophoblast invasion early in pregnancy. Knowledge of the development of the early placenta and the establishment of the fetomaternal circulation assists in understanding the origins of placental dysfunction which manifest later in pregnancy. Perinatally, chronic placental dysfunction may result in a growth-restricted fetus, maternal problems such as gestational hypertension, pre-eclampsia, eclampsia and pregnancy complications such as placental abruption, preterm labour and delivery. In addition, the growth-restricted fetus and the mother are at an increased risk of a myriad of disorders later in life. The role of ultrasound in the assessment of first trimester pregnancy is evolving with the potential for value in the prediction of placental function in later pregnancy. This review will address two aims, first to describe the development of the placenta from fertilisation to 12 weeks' gestation, correlating this with first trimester ultrasound findings. Second, to describe the link between placental development and function later in pregnancy. Understanding the link between early placental development and later placental function is essential in directing the focus of new research addressing the role of ultrasound in the first trimester in the prediction of adverse obstetric outcomes.

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Threatened abortion: sonographic distinction of normal and abnormal gestation sacs.

Cited by 109 publications

References 0 publications

Value of the yolk sac in evaluating early pregnancies.

Value of the yolk sac in evaluating early pregnancies.

Evaluation of Early Pregnancy Failure with Ultrasound

The developmental origins of placental function

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