Outcome of First Trimester Pregnancy in cases with impending embryonic demise (original) (raw)
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Prediction of First-Trimester Miscarriage from Embryonic Bradycardia and Embryonic Growth Delay
Journal of Obstetrics and Gynaecology, 1995
Objective: The purpose of this study was to determine whether subsequent and simultaneous measurements of embryonic heart rate (EHR) and crown-rump length (CRL) are useful in predicting miscarriage. Study Design: A prospective cross-sectional study was performed on miscarriages with detectable embryonic heart rate (n = 33). Chromosomal tests were carried out in 9 of 33 cases. In cases with embryonic bradycardia and/or embryonic growth delay, the mean CRL was 6.6 mm (n = 16), and embryonic death occurred at CRL values under 20 mm. In cases where neither bradycardia nor growth delay was detected, the CRL was 23.9 mm (n = 17) at embryonic death. Chromosomal abnormalities were present as triploidy (n = 5) and trisomy-16 (n = 2) in both bradycardia and embryonic-growth-delay cases.
Fetal loss in threatened abortion after embryonic/fetal heart activity
International Journal of Gynecology & Obstetrics, 2003
Objectives: To study the incidence of fetal loss in threatened abortion after detection of embryonicyfetal heart activity. Methods: A prospective study was performed on pregnant women with clinically diagnosed threatened abortion between 6 and 14 weeks of gestation. All had a good menstrual history and the calculated gestational age using crown-rump length in the first trimester ultrasound was in agreement. Embryonicyfetal heart rate measurements were obtained by a 5 MHz vaginal probe using M-mode and real-time B mode imaging. All cases were followed up with respect to pregnancy outcomes. The data were analyzed using the SPSS computer program. Results: Eighty-seven pregnant women were included in the study. There were three pregnancies (3.4%) which resulted in fetal loss before 20 weeks of gestation. In viable pregnancies, the mean embryonicyfetal heart rate increased with advancing gestational age. The individual values of embryonicyfetal heart rate for fetal losses were within the reference range. Conclusions: The incidence of fetal loss in threatened abortion after detection of embryonicyfetal heart activity was 3.4%. There was no evident pattern of bradycardia or tachycardia that signaled the incipient of viability.
2015
It has been previously suggested that abnormal yolk sac characteristics and slow embryonic foetal heart rate = are associated with poor gestational outcome and these parameters can be used to assess foetal viability in first trimester of pregnancies. However there is paucity of evidence in Indian medical literature. The purpose of present study was to examine the role of yolk sac characteristics and early embryonic heart rate (EHR) between 6 to 9 weeks of pregnancies and to study their associations with spontaneous abortions. This prospective observational study included 280 low risk healthy singleton pregnant women attending antenatal clinic in a tertiary medical institution in early gestation. Transvaginal ultrasound was carried out to quantify yolk sac morphometry and using M mode, early embryonic heart rate was measured. 90% (252/280) of subjects satisfied normal yolk sac morphometry according to Nyberg criteria and 99.2% of them (250/252) had ongoing pregnancies. 28 patients ha...
Clinical study of various risk factors associated with intrauterine fetal death
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2017
Background: The death of a fetus is one of the unhappy events in the field of obstetrics. It is really distressing when it occurs without warning in a pregnancy that has previously entirely normal. It is thus vital to identify specific probable causes of fetal death to determine the risk of recurrence, prevention or corrective action. Methods: A prospective observational study was conducted in ESIC MC and PGIMSR, Rajajinagar, Bangalore, Karnataka, India. All cases of intrauterine fetal death confirmed either with ultrasound or on clinical examination by absence of fetal heart rate and fetal movements were studied. The age, parity, literacy, socioeconomic status was recorded. Detailed history, clinical examination, associated conditions. Mode of delivery and details of the fetus and their placentas were noted. They were followed for 3 days for complications. Results: Mean maternal age was 26.03yrs, 98.5% of the women were booked cases, 82% belonged to lower middle class.16.39% of the women had hypertensive disorder of pregnancy, 4.91% had gestational diabetes, 9.8% had abruption placentae, 9.8% had oligohydramnios and 1.63% had polyhydramnios 4.9% were Rh isoimmunisation, 1.9% had twin pregnancy, 3.27% had PROM, 6.6% had cord accidents, 21% had anomalous fetus, 3.27% foetuses had non immune hydrops, 19.67% of IUDs were unexplained. Conclusions: Unexplained causes, PIH and abruptio placentae were major causes of IUFD. Significant proportion of IUFD due to PIH and abruption placenta is preventable by regular antenatal care and timely intervention. Despite advances in diagnostic and therapeutic modalities large number of fetal deaths remain unexplained. Poverty, illiteracy, unawareness and inaccessibility may be some of the reasons for unexplained IUFD.
THE PREVENTABLE CAUSES RELATED OF INTRAUTERINE FETAL DEATH IN KING ABDULAZIZ UNIVERSITY
Background: -Intrauterine fetal death (IUFD) is a depressing event for the families and their doctors. This study aimed to determine associated maternal and fetal risk factors to IUFD. Method:- This retrospective study included all IUFD cases admitted to the emergency room and OB/ GYN department at King Abdulaziz University Hospital from January , 2015 to May, 2016. Result:- The study enrolled 120 IUFD cases , with mean maternal age 32.8+6.57 , gestational age mean score 32.03+6.54, 25 (20.3%) cases reported medical history. More than third (44- 36.7%) reported antenatal care (ANC) services, and only14 (11.7%) cases reported previous IUFD.In 70 (58.3%) cases absent fetal heart beat was recorded 44 (36.7%) cases absent fetal movement was recorded .Almost the half of the cases (59 – 49.2%) reported induction of labor.ER admission recorded 110 (91.7%) cases .Placenta was sent to histopathology in the majority of cases (104-86.7%). Conclusion:- Several factors were associated with IUFD cases , most of them are preventable if there is good ANC , there is need for more campaigns and educational programs to increase the level of awareness about the benefits of ANC.
Pregnancy Outcome of Threatened Abortion with Demonstrable Fetal Cardiac Activity: A Cohort Study
Journal of Obstetrics and Gynaecology, 1995
Pregnancy with visible fetal heart beat complicated by first trimester threatened abortion had significant increased risk of subsequent spontaneous abortion compared with normal pregnancy. T o compare pregnancy outcomes in cases complicated by first trimester threatened abortion with those that were not. Prospective cohort study of 255 cases of first trimester threatened abortions but with visible heart beat and 265 other normal pregnancies. Spontaneous abortion rates of 5.5'%, (with relative abortal risk of 2.91) was found for study group, compared to 1.88% for controls (p < 0.05). Preterm delivery was also higher, but was not statistically significant. First trimester bleeding with visible fetal heart beat appears to associate significantly with higher subsequent spontaneous abortion rate than those without.
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2016
Background: Amongst various community health indicators available for measurement of quality and impact of health services in developing countries, perinatal mortality finds its position as being one of the top most single indicators even today. In order to have a decrease of the fetal mortality rate, it is necessary to know the etiology of fetal death and its associated risk factors in different populations. Thus the purpose of this study was to investigate about the prevalence, patient profile, socio-demographical and etiological risk factors associated with fetal losses beyond 24 weeks of pregnancy in our hospital.
Risk Factors associated with Intrauterine Fetal Death at Birat Medical College Teaching Hospital
Janaki Medical College Journal of Medical Science
Background & Objective: Intrauterine fetal death is a tragic event, and despite efforts to reduce its incidence, it remains challenging to do so. Intrauterine fetal death is an important indicator of the maternal and perinatal health of a given population. This study aims to identify the maternal and fetal factors associated with intrauterine fetal death. Material and Methods: This is a descriptive cross-sectional study conducted in Obstetrics ward of Birat Medical College Teaching Hospital from 1st July 2021 to 31st August 2022. All pregnant women with ultrasound confirmed intrauterine fetal death after 28 or more weeks gestation who were admitted to the Obstetrics ward of Birat Medical College Teaching Hospital in the study period were enrolled in the study. Results: There were 4562 antenatal admissions and 3852 deliveries in the study period. Of these, 35 pregnant women were admitted with intrauterine fetal death. The intrauterine fetal death rate was 11 per 1000 deliveries in ou...