First-trimester ultrasound features associated with subsequent miscarriage: A prospective study

Area of Science:

• Obstetrics and Gynecology
• Medical Imaging
• Reproductive Medicine

Background:

• First-trimester miscarriage is a common pregnancy complication.
• Early ultrasound scans are frequently used to assess pregnancy viability.
• Ultrasound plays a crucial role in managing early pregnancy.

Purpose of the Study:

• To identify differences in early ultrasound findings between viable pregnancies and those ending in miscarriage before 12 weeks.
• To develop a predictive model for first-trimester miscarriage using ultrasound parameters.

Main Methods:

• Prospective cohort study design.
• Collected ultrasound measurements including mean sac diameter (MSD), yolk sac diameter (YSD), crown-rump length (CRL), fetal heart rate (FHR), trophoblast thickness, trophoblast volume (TTV), and mean uterine artery pulsatility index (meanUAPI).
• Used regression models and logistic regression to compare Z-scores and build a prediction model for miscarriage.

Main Results:

• Significant variations in Z-scores were observed for meanUAPI, TTV, FHR, and MSD between viable and miscarrying groups.
• The logistic regression model achieved an area under the receiver operator curve of 0.81.
• The model demonstrated a sensitivity of 76% at a 30% false-positive rate for predicting miscarriage.

Conclusions:

• Combining FHR, meanUAPI, and TTV in a prediction model shows potential for miscarriage prediction.
• This model may assist in the ongoing management of pregnancies in the first trimester.
• Ultrasound parameters offer valuable insights into early pregnancy outcomes.