Document Detail

Transvaginal ultrasound in threatened abortions with empty gestational sacs.
MedLine Citation:
PMID:  7805999     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine whether transvaginal ultrasound criteria alone can distinguish viable from non-viable gestational sacs at a single examination. METHOD: A prospective descriptive study was undertaken and analysis performed on 211 pregnancies complicated by threatened abortion and empty gestation sacs diagnosed by transvaginal ultrasound. The main outcome measure was the final diagnosis of viable or non-viable gestation on subsequent transvaginal sonography. RESULTS: The study shows that a single transvaginal ultrasound examination is useful in differentiating viable from non-viable gestation sacs. The mean sac diameter (MSD) was found to be the most useful criterion for determining non-viability. An MSD of > or = 17 mm that lacked an embryo and an MSD of > or = 13 mm without visible yolk sac were reliable predictors of non-viable gestation sacs at a single examination with 100% specificity and 100% positive predictive value. An MSD > or = 13 mm without visible yolk sac was the most sensitive criterion. Using MSD criteria, 73% of non-viable gestations could be reliably identified without any false-positive diagnoses. Deformed shape, low position and thin decidual reaction are strong indicators of non-viable gestations but are not 100% accurate. There is still a significant proportion of empty sacs, where no accurate distinction between viable and non-viable can be made according to one criterion at a single examination and in these cases serial examinations should be carried out before any active management is advocated. CONCLUSION: In most cases, transvaginal sonographic criteria alone can distinguish viable from non-viable empty gestational sacs at a single examination.
T Tongsong; C Wanapirak; J Srisomboon; S Sirichotiyakul; T Polsrisuthikul; S Pongsatha
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics     Volume:  46     ISSN:  0020-7292     ISO Abbreviation:  Int J Gynaecol Obstet     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1995-01-30     Completed Date:  1995-01-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0210174     Medline TA:  Int J Gynaecol Obstet     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  297-301     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Thailand.
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MeSH Terms
Abortion, Threatened / ultrasonography*
Diagnosis, Differential
Fetal Death / ultrasonography*
Pregnancy Outcome
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Ultrasonography, Prenatal / instrumentation,  methods*
Yolk Sac / ultrasonography*

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