Ultrasound in Prediction of Threatened Abortion in Early Pregnancy: A clinical Study

Background: early pregnancy loss is a challenging health problem and the prediction of exposed females is mandatory to permit early intervention and prevention. Aim of the work: to assess utility of ultrasound in detection of threatened abortion in early pregnancy. Patients and methods: one hundred females with history of threatened abortion were included. A written consent was obtained from each participant. Patients were divided into two groups: Group (I): 85 Cases who continued their pregnancy. Group (II): 15 Cases ended by abortion. All females were submitted to: detailed history, clinical examination (General and abdominal) and investigations in the form of ultrasound. Data were collected and statistically analyzed. Results: 15% of studied females had early miscarriage. There was a significant relation between occurrence of abortion and gestational age as abortion was more frequent with reduced gestational age. In addition, high parity (P1-2) was significantly associated with abortion. Also, current abortion associated with abortion in previous pregnancy, sub-chorionic hematoma, irregular wall of gestational sac and low fetal heart rate. The best cutoff of fetal heart rate is 100 beat/minute. The sensitivity of fetal heart rate in prediction of abortion was 67.1%, specificity was 80.0%, PPV was 95.0%, NPV was 30.0% and overall accuracy was 69%. Conclusion: The sonographic findings have a prognostic value that interacts with other clinical and maternal factors analyzed. Some parameters considered as prognostic factors and include irregular wall of gestational sac, perigestational hemorrhage and embryonic bradycardia