Recurrent Pregnancy Loss Clinical Trial
Official title:
Ultrasound Predictors of Early Pregnancy Failure in Patients With Recurrent Pregnancy Loss
evaluation of the role of ultrasonographic parameters (mean gestational sac diameter, yolk sac diameter, crown rump length, embryonic heart rate and uterine artery Doppler) in predicting early pregnancy failure in patients with recurrent pregnancy loss
1. Mean gestational sac diameter (MSD) is determined by measuring the mean of 3 diameters
(longitudinal, antero-posterior and transverse) which are measured from inside of the
sac excluding the decidual reaction from the measurement. It is normally eccentric in
location embedded in endometrium, and has a smooth; round or oval shape.
2. Yolk sac is measured by placing calipers on the inner limits of the longer diameter. It
usually appears at the periphery of the gestational sac and should not be floating
within the sac. Size of the sac, shape, echogenicity of the rim and center of sac, its
number and degenerative changes such as calcification will be evaluated. YS having
diameter between 3-7mm, rounded shape, absence of degenerative changes, presence of
echogenic rim and hypoechoic center are considered normal. Any deviation from above
parameters is considered abnormal.
3. Crown-rump length (CRL) is the length of the embryo from the top of its head to bottom
of torso excluding the yolk sac and the extremities, to be measured in sagittal plane of
the embryo and recorded as an average of three measurements.
4. The MGSD-CRL ratio was calculated as the difference between the MGSD and the CRL if less
than 5 mm are prone to first trimester miscarriage.
5. Embryonic heart rate by M-mode calculated as beat per minute using software of
ultrasound machine after measuring by electronic calibers of distance between 2 heart
waves on frozen M-mode image.
6. Uterine artery Doppler with measurement of systolic/diastolic (S/D) ratio, resistance
index (RI) and pulsatility index (PI) of uterine arteries.
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