| A model and scoring system to predict outcome of intrauterine pregnancies of uncertain viability. | |
| | |
MedLine Citation:
|
PMID: 21520315 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
|
OBJECTIVES: To define the incidence and outcome of intrauterine pregnancy of uncertain viability (PUV) and to develop and assess the performance of a model and a scoring system to predict ongoing viability. METHODS: Of 1881 consecutive women undergoing transvaginal ultrasonography, a cohort of 493 women with an empty gestational sac < 20 mm in mean diameter, gestational sac < 25 mm in mean diameter and containing yolk sac only or an embryonic pole < 6 mm in maximum length and without visible heart activity were followed until the end of the first trimester. Women with multiple pregnancies or who underwent termination of pregnancy were excluded. Outcome measures were pregnancy viability at initial 7-14-day follow-up and first-trimester viability at 11-14 weeks. The data were split randomly into two sets (two-thirds and one-third, respectively) in order to first develop and then test a mathematical model and a 'simple' model in the prediction of viability at each outcome point, based on maternal demographics, ultrasound features and symptoms. The performance of each system was assessed by receiver-operating characteristics (ROC) curve analysis and calibration plots on a test dataset. RESULTS: The incidence of PUV in this population was 29.2% (549/1881). Of the 493 pregnancies with initial (7-14 days) follow-up available, 307 (62.3%) were viable at this time and of the 444 pregnancies with follow-up at the end of the first trimester, 225 (50.7%) were still viable. Initial (7-14-day) viability was predicted by the model with an area under the ROC curve (AUC) of 0.837 (95% CI, 0.791-0.884) in the training dataset and 0.821 (95% CI, 0.756-0.885) in the test dataset. First-trimester (11-14-week) viability was predicted by the model with an AUC of 0.788 (95% CI, 0.734-0.842) in the training dataset and 0.774 (95% CI, 0.701-0.848) in the test dataset. The scoring system performed slightly worse than did the model, but had the advantage of being easily applicable. CONCLUSIONS: When early pregnancy viability cannot be established immediately with ultrasound, use of either a logistic regression model or a scoring system allows an individualized prediction of first-trimester outcome. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
| | |
Authors:
|
C Bottomley; V Van Belle; A Pexsters; A T Papageorghiou; F Mukri; E Kirk; S Van Huffel; D Timmerman; T Bourne |
Related Documents
:
|
2943105 - Detached ciliary tufts in pouch of douglas fluid. 2653415 - Efficacy of progesterone support for pregnancy in women with recurrent miscarriage. a m... 21315145 - Chronic ethanol exposure and folic acid supplementation: fetal growth and folate status... 21512965 - Genetic variation in macrophage migration inhibitory factor associated with gestational... 11155325 - In vitro fertilization and intracytoplasmic sperm injection for couples with unexplaine... 8594535 - Changes in intracellular ph close to term and their possible significance to labour. |
Publication Detail:
|
Type: Journal Article |
Journal Detail:
|
Title: Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology Volume: 37 ISSN: 1469-0705 ISO Abbreviation: Ultrasound Obstet Gynecol Publication Date: 2011 May |
Date Detail:
|
Created Date: 2011-04-26 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 9108340 Medline TA: Ultrasound Obstet Gynecol Country: England |
Other Details:
|
Languages: eng Pagination: 588-95 Citation Subset: IM |
Copyright Information:
|
Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. |
Affiliation:
|
Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital London, London, UK. ceciliabottomley@doctors.org.uk. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The CUSUM test applied in prospective nuchal translucency quality review.
Next Document: Early screening for pre-eclampsia and intrauterine growth restriction.