Abortion Threatened Clinical Trial
Official title:
Biochemical Versus Ultrasound Findings as Predictors of Fetal Loss in Cases of First Trimester Threatened Miscarriage
Threatened miscarriage occurs in about one-fifth of pregnancies with an estimated miscarriage
rate of 3-16% after successful demonstration of fetal cardiac activity. Various biochemical
markers have been studied previously to predict the outcome of threatened miscarriage;
However, the results have been conflicting. Several studies have documented that a slow
embryonic heart rate at 6.0-7.0 Weeks' gestation is associated with a high rate of first
trimester fetal demise.
our aim: To evaluate the accuracy of ultrasound findings in comparison to serum CA125 and
progesterone in predicting fetal demise in cases of first trimester threatened miscarriage.
Will this pregnancy be continued after the first trimester or not?
we are comparing between the accuracy of vaginal ultra sound versus serum progesterone level
and serum CA 125 level in predicting of fetal demise in cases of threatened miscarriage three
vaginal ultrasounds will be done ) the first one will be done at six to eight weeks of
pregnancy to the patients who fulfill the criteria in this us we will make sure that the
cardiac pulsations are present and measure the following:
1. the fetal heart rate,
2. the crown rump length
3. gestational sac diameter
4. yolk sac diameter. b) The second ultra sound will be after two weeks from the first one
to follow up the patient for pregnancy survival, take the same measures again and
correlate them with the results of laboratory investigations to select the investigation
which is most accurate in anticipating outcome in cases of threatened abortion.
C) the third one will be at the end of first trimester (13 weeks) to ensure fetal viability.
. embryonic bradycardia and absence of yolk sac or smaller yolk sac than expected for any
given gestational age are prognostic factors of poor pregnancy outcome in the first 12 weeks
of pregnancy women with small for age gestational sac are more prone to have miscarriage we
will do laboratory investigation in the form of A) Serum progesterone: low maternal P levels
have been useful in predicting spontaneous abortion in threatened pregnancies with a
sensitivity of 80% (<10 ng /mL) so, this will be our cutoff value. B) Serum CA 125 :we will
take a level of 51.5 as cut off value.this is the upper level of normal we will do them once
when the patient presents to us.
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