The value of current triple ultrasonographic markers in cases of unexplained early recurrent miscarriage

Introduction: Recurrent miscarriage is the loss of three or more consecutive pregnancies before 20 weeks or fetal weight of 500 grams. Seventy five percent of these cases occur in the first trimester. Several studies investigated ultrasonographic landmarks to try to differentiate between normal and abnormal pregnancies. Objective: Differentiate between normal and abnormal pregnancy using three ultrasound markers: fetal heart rate, gestational and yolk sac diameters. Study design: Prospective observational study. Patients and methods: One hundred and sixty patients carrying a singleton intrauterine pregnancy within the first seven weeks of pregnancy with three or more unexplained consecutive pregnancy loss did weekly serial transvaginal ultrasound from 5 until 13 weeks the latter gestation was performed by transabdominal ultrasound to measure gestational and yolk sac diameters and fetal heart rate. Results: There was a significant difference in fetal heart rate, gestational and yolk sac diameters on weekly basis as pregnancy advances. There was a significant difference in fetal heart rate and yolk sac diameter between normal and abnormal pregnancies (P < 0.001), however, this was insignificant as regards gestational sac diameter. Conclusion: Multiple ultrasound parameters with serial examinations are better than a single parameter or examination in predicting pregnancy outcome in cases with recurrent unexplained first trimester miscarriage.