Document Detail

Relationship between crown-rump length and early detection of cardiac activity.
MedLine Citation:
PMID:  17583234     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate whether improvements in sonographic technology would allow detection of embryonic demise at a crown-rump length (CRL) < 5 mm. STUDY DESIGN: A prospectively collected, computerized ultrasound database was queried for singleton gestations with CRL < or = 5 mm from January 2000 to February 2003. Embryonic viability was determined by repeat ultrasound examination after 6 weeks'gestation confirming cardiac activity or by documentation of an ongoing pregnancy. Viability rates in the presence or absence of cardiac activity were calculated for CRL of 2.0-2.9, 3.0-3.4, 3.5-3.9, 4.0-4.4, 4.5-4.9 and 5.0 mm. Sensitivity, specificity, positive predictive value and negative predictive value for embryonic demise were calculated, with a subanalysis based on the presence of vaginal bleeding. RESULTS: Outcome was available for 179 of 195 gestations meeting inclusion criteria. The absence of cardiac activity at CRL > or = 3.5 mm had 100% positive predictive value and specificity. The presence of vaginal bleeding did not affect this cutoff. CONCLUSION: Improved sonographic technology permits diagnosis of embryonic demise at a CRL > or = 3.5 mm under ideal conditions. Vaginal bleeding increases the likelihood of demise, but does not alter test performance. Further investigation is warranted, as our data suggest a limit closer to 3 mm.
Lisa N Abaid; Sawsan As-Sanie; Honor M Wolfe
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  The Journal of reproductive medicine     Volume:  52     ISSN:  0024-7758     ISO Abbreviation:  J Reprod Med     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-06-22     Completed Date:  2007-07-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0173343     Medline TA:  J Reprod Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  375-8     Citation Subset:  IM    
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 101 Manning Drive, CB 7570, Chapel Hill, NC 27599-7570, USA.
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MeSH Terms
Crown-Rump Length*
Databases, Factual
Fetal Death / ultrasonography*
Fetal Heart / ultrasonography*
Predictive Value of Tests
Pregnancy Trimester, First
Prospective Studies
Sensitivity and Specificity
Ultrasonography, Prenatal*

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