This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Laufer, M. R. Articles by Hill, J. A. Search for Related Content PubMed PubMed Citation Articles by Laufer, M. R. Articles by Ecker, J. L. Articles by Hill, J. A. Social Bookmarking                         What's this?

Pregnancy Outcome Following Ultrasound-Detected Fetal Cardiac Activity in Women With a History of Multiple Spontaneous Abortions

Fearing Research Laboratory and The Recurrent Miscarriage Center, Division of Reproductive Immunology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

Jeffrey L. Ecker, MD

Fearing Research Laboratory and The Recurrent Miscarriage Center, Division of Reproductive Immunology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

Joseph A. Hill, MD

Fearing Research Laboratory and The Recurrent Miscarriage Center, Division of Reproductive Immunology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts

OBJECTIVE: To determine whether women with two or more previous spontaneous abortions of unknown etiology, by conventional testing criteria, have a different rate of subsequent fetal loss than controls after ultrasonic documentation of fetal cardiac activity.

METHODS: Medical records were reviewed from 185 women with spontaneous abortion of unknown etiology. Of these women, 91.9% were found to have evidence of cellular immunity to trophoblast and were treated with progesterone for immunosuppression. Ultrasound evaluation was obtained at 5-6 weeks' gestation to document fetal cardiac activity. A control group of 63 women was also studied. All women were followed for pregnancy outcome.

RESULTS: A total of 248 pregnancies were identified from the 185 study patients with multiple spontaneous abortions. Fetal cardiac activity was visualized by ultrasound in 209 pregnancies from 171 study subjects; of these, the outcomes of 208 pregnancies were known. The rate ofspontaneous abortion after ultrasound documentation of fetal cardiac activity was 22.7%. Neither maternal age nor number of previous losses was associated with an increased incidence of spontaneous abortion following documentation of fetal cardiac activity. The rate of spontaneous abortion in the control group after documentation of fetal cardiac activity was 3.3%.

CONCLUSION: These data may help clinicians give couples who have experienced recurrent pregnancy loss a more realistic prognosis for pregnancy success once fetal cardiac activity has been confirmed. (J Soc Gynecol Invest 1994;1:138-42)

Key Words: Ultrasound • cardiac activity • recurrent abortion.

Journal of the Society for Gynecologic Investigation, Vol. 1, No. 2, 138-142 (1994)
DOI: 10.1177/107155769400100208


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?