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The Role of Ultrasonographic Markers for Prediction of First Trimester Pregnancy Outcomes

Yıl 2015, Cilt: 12 Sayı: 2, 75 - 79, 01.03.2015

Öz

Aim: To examine certain ultrasonographic parameters during the first trimester of pregnancy and determining their role to predict first trimester outcome.Material and Methods: It’s a prospective cohort study including 210 pregnant women that admitted to antenatal care unit of Etlik Zübeyde Hanım Women’s Health Training and Research Hospital. Patients’ gestational age were calculated according to last menstrual period. Embryonic heart rate and yolk sac diameter were evaluated ultrasonographically during the first 12 weeks of pregnancy and then patients who have lost their conceptus were confronted with non-aborted ones at the end of 12 weeks of pregnancy. Mono-directional variance analysis was used to determine the correlation between yolk sac diameter and menstrual age, also between embryonic heart rate and menstrual age. Menstrual Age minus Mean Sac Diameter related Age , ‘Yolk Sac Diameter/Mean Sac Diameter ratio’, ‘ Mean Sac Diameter minus Crown-Rump Length ’ were compared between ‘the group of first trimester aborted’ and ‘the group of first trimester non-aborted’ with Independent T-Test. Regression analysis was performed for parameters, suitable graphs and curves were drawn. Fisher Exact Test was performed to determine the decisiveness of ‘Embrional Heart Rate < 120/ minute’ and ‘ Menstrual Age minus Mean Sac Diameter related Age ’ values.Results: Yolk sac diameter was decisive to predict abortion except 6-8 weeks of first trimester pregnancy p≤0.001 . Yolk sac diameters were increasing as gestational sac diameter and CRL Crown-Rump Length increased. Embryonic heart rate lesser than 120 pulse per minute was substantially decisive to predict abortion in all groups p

Kaynakça

  • Garmel SH. Early pregnancy risk. In: De Cherney AH, Nathan L. Current Obstetrics and Gynecology; Diagnosis and Treatment, 10th edn, USA: Mc Graw-Hill Companies. 2007; 272.
  • Jauniaux E, Jurkovic D, Henriet Y, Rodesch F, Hustin J. Development of the secondary human yolk sac: correlation of sonographic and anatomic features. Hum Reprod. 1991; 6: 1160–6.
  • Figueras F, Torrents M, Munoz A. Three-dimensionalyolk and gestational sac volume. A prospective study of prognostic value. J Reprod Med. 2003; 48:252.
  • Küçük T, Duru NK, Yenen MC, Dede M, Ergun A, Başer İ. Yolk sac size and shape as predictors of poor pregnancy outcome. J Perinat Med.1999;27:316.
  • Jauniaux E, Gulbis B, Jurkovic D, Gavriil P, Campbell S. The origin of alp- ha-fetoprotein in first trimester anembryonic pregnancies. Am J Obstet Gynecol. 1995; 173:1749–53.
  • Doubilet PM, Benson CB. Outcome of first trimester pregnancies with slow embriyonic heart rate at 6-7 weeks gestation and normal heart rate by 8 weeks at US, Radiology. 2005; 236:643.
  • Yapar EG, Ekici E, Gokmen O. First trimester fetal heart rate measure- ments by transvaginal ultrasound combined with pulsed Doppler: an evaluation of 1331 cases. Eur J Obstet Gynecol Reprod Biol. 1995; 60: 133–7.
  • Tharangrut Hanprasertpong, Vorapong Phupong. First trimester embri- yonic/ fetal heart rate in normal pregnant women. Arch Gynecol Obstet. 2006; 274:257.
  • Shenker L, Astle C, Reed K, Anderson C 1986, Embriyonic heart rates before the seventh week of pregnancy. J Reprod Med. 31:333-5.
  • Walker AM, Cannata J, Dowling MH, Ritchie B, Maloney JE. Sympathetic and parasympathetic control of heart rate in unanaesthetized fetal and newborn lambs. Biol Neonate 1978;33:135-43.
  • Qasim SM; Sachdev R, Trias A, Senkowski K; Kemmann E. The predic- tive value of first-trimester embriyonic heart rates in infertility patients. Obstet Gynecol 1997; 89: 934.
  • Brigham SA; Conlon C, Farquharson RG: A longitudinal study of preg- nancy outcome following idiopathic recurrent miscarriage. Hum Reprod 2002; 14:2868.
  • Chittacharoen A, Herabutya Y. Slow fetal heart rate may predict pregnan- cy outcome in first-trimester threatened abortion. Fertil Steril 2004; 82: 227
  • Opshal MS, Pettit DC. Fist trimester sonographic characteristics of pa- tients with recurrent spontaneous abortion. J Ultrasound Med 1993; 12: 507-10.
  • Altay M, Yaz H, Haberal A. The assesssment of the gestational sac di- ameter, crown-rump length, progesterone and fetal heart rate measure- ments at the 10th gestational week to predict the spontaneous abortion risk. J Obstet Gynaecol Res 2009; 35: 287-292.

Ultrasonografik Belirteçlerin İlk Trimester Gebelik Sonuçlarını Öngörmedeki Rolü

Yıl 2015, Cilt: 12 Sayı: 2, 75 - 79, 01.03.2015

Öz

Amaç: İlk trimester boyunca bazı ultrasonografik parametrelerin incelenmesi ve ilk trimester gebelik sonuçlarını öngörmedeki rolünü araştırmak.Gereç ve Yöntemler: Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim Araştırma Hastanesi gebe polikliniğinde 210 kadını içeren prospektif kohort çalışması gerçekleştirildi. Gestasyonel yaş, son adet tarihine SAT dayalı olarak hesaplandı. Embriyonel kalp atım hızı EKAH ve yolk kese çapı ilk 12 hafta boyunca değerlendirildi ve takiben gebelikler ilk trimesterin ötesinde devam edenler ve spontan abortus ile sonuçlananlar arasında karşılaştırıldı. Tek yönlü varyans analizi yolk kese çapı ve menstrüel yaş SAT’a göre yaş arası ilişkiyi, EKAH ve menstruel yaş arası ilişkiyi değerlendirmek için kullanıldı. SAT yaşı - OKÇ Ortalama Kese Çapı yaşı farkı, Yolk kese çapının OKÇ’na oranı, OKÇ-CRL CRL Crown-Rump Length : Baş-popo mesafesi farkı düşük yapan ve yapmayan grupta bağımsız t-testi ile karşılaştırıldı. Parametreler için regresyon analizi uygulandı ve uygun eğrileri çizildi. Fisher Exact testi, EKAH 5,5 gün değerinin belirleyiciliği için kullanıldı.Bulgular: Yolk kesesi çapı tüm gruplarda bakıldığında anlamlı farklılık 6-8 hf dışındaki gebelerde saptandı p≤0.001 . Yolk kesesi çapı, gestasyonel kese çapı ve CRL uzunluğu arttıkça artmaktadır. EKAH açısından düşük yapan hastalarla, gebeliği 12 haftanın ötesinde devam edenler arasında anlamlı farklılık saptandı p

Kaynakça

  • Garmel SH. Early pregnancy risk. In: De Cherney AH, Nathan L. Current Obstetrics and Gynecology; Diagnosis and Treatment, 10th edn, USA: Mc Graw-Hill Companies. 2007; 272.
  • Jauniaux E, Jurkovic D, Henriet Y, Rodesch F, Hustin J. Development of the secondary human yolk sac: correlation of sonographic and anatomic features. Hum Reprod. 1991; 6: 1160–6.
  • Figueras F, Torrents M, Munoz A. Three-dimensionalyolk and gestational sac volume. A prospective study of prognostic value. J Reprod Med. 2003; 48:252.
  • Küçük T, Duru NK, Yenen MC, Dede M, Ergun A, Başer İ. Yolk sac size and shape as predictors of poor pregnancy outcome. J Perinat Med.1999;27:316.
  • Jauniaux E, Gulbis B, Jurkovic D, Gavriil P, Campbell S. The origin of alp- ha-fetoprotein in first trimester anembryonic pregnancies. Am J Obstet Gynecol. 1995; 173:1749–53.
  • Doubilet PM, Benson CB. Outcome of first trimester pregnancies with slow embriyonic heart rate at 6-7 weeks gestation and normal heart rate by 8 weeks at US, Radiology. 2005; 236:643.
  • Yapar EG, Ekici E, Gokmen O. First trimester fetal heart rate measure- ments by transvaginal ultrasound combined with pulsed Doppler: an evaluation of 1331 cases. Eur J Obstet Gynecol Reprod Biol. 1995; 60: 133–7.
  • Tharangrut Hanprasertpong, Vorapong Phupong. First trimester embri- yonic/ fetal heart rate in normal pregnant women. Arch Gynecol Obstet. 2006; 274:257.
  • Shenker L, Astle C, Reed K, Anderson C 1986, Embriyonic heart rates before the seventh week of pregnancy. J Reprod Med. 31:333-5.
  • Walker AM, Cannata J, Dowling MH, Ritchie B, Maloney JE. Sympathetic and parasympathetic control of heart rate in unanaesthetized fetal and newborn lambs. Biol Neonate 1978;33:135-43.
  • Qasim SM; Sachdev R, Trias A, Senkowski K; Kemmann E. The predic- tive value of first-trimester embriyonic heart rates in infertility patients. Obstet Gynecol 1997; 89: 934.
  • Brigham SA; Conlon C, Farquharson RG: A longitudinal study of preg- nancy outcome following idiopathic recurrent miscarriage. Hum Reprod 2002; 14:2868.
  • Chittacharoen A, Herabutya Y. Slow fetal heart rate may predict pregnan- cy outcome in first-trimester threatened abortion. Fertil Steril 2004; 82: 227
  • Opshal MS, Pettit DC. Fist trimester sonographic characteristics of pa- tients with recurrent spontaneous abortion. J Ultrasound Med 1993; 12: 507-10.
  • Altay M, Yaz H, Haberal A. The assesssment of the gestational sac di- ameter, crown-rump length, progesterone and fetal heart rate measure- ments at the 10th gestational week to predict the spontaneous abortion risk. J Obstet Gynaecol Res 2009; 35: 287-292.
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Research Article
Yazarlar

Ebru Ersoy Bu kişi benim

Ali Özgür Ersoy Bu kişi benim

Esra Yaşar Çelik Bu kişi benim

Sibel Özler Bu kişi benim

Metin Altay Bu kişi benim

Orhan Gelişen Bu kişi benim

Yayımlanma Tarihi 1 Mart 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 12 Sayı: 2

Kaynak Göster

Vancouver Ersoy E, Ersoy AÖ, Yaşar Çelik E, Özler S, Altay M, Gelişen O. Ultrasonografik Belirteçlerin İlk Trimester Gebelik Sonuçlarını Öngörmedeki Rolü. JGON. 2015;12(2):75-9.