Mechanism of recurrent spontaneous abortion. I. Ultrasonographic findings.

Abstract

Our objective was to study the mechanisms of early pregnancy loss with ultrasonographic findings in pregnancies that terminated in repeat abortion in women with recurrent spontaneous abortion compared with patients with spontaneous abortion with no previous spontaneous abortion and with women with recurrent spontaneous abortion who had viable pregnancies. A prospective, unselected study of 83 pregnancies followed from 4 to 12 weeks of gestation. Weekly transvaginal ultrasonography.among 43 pregnancies terminating in abortion were compared with 40 pregnancies ending in live birth with the Fisher exact test with a p value of significance assigned at less than 0.05. A significant difference in the presence of fetal heart activity was observed at 6 weeks +/- 5 days among women who subsequently aborted when recurrent spontaneous abortions were compared with no history of abortion (55% and 14%, p less than 0.02). Fetal pole size was small in 86% of pregnancies lost after fetal heart activity. Ultrasonographic examination at 6 weeks can diagnose impending abortion with a sensitivity of 85%, specificity of 93%, positive predictive value of 92%, and negative predictive value of 87% among women with recurrent spontaneous abortion.