Document Detail


The yolk stalk sign: evidence of death in small embryos without heartbeats.
MedLine Citation:
PMID:  20103794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The purpose of this study was to assess the positive predictive value for confirming early embryonic death in the clinical sonographic scenario wherein an embryo is identified without a visible heartbeat; the embryonic crown-rump length (CRL) is 5 mm or less; and the embryo is not immediately adjacent to the yolk sac. METHODS: A retrospective study of 882 first-trimester sonograms was performed among women who had an intrauterine pregnancy of uncertain viability based on 1 or more sonographic findings (eg, no visible heartbeat in an embryo with a CRL of < or =5 mm). Eight hundred six cases met the inclusion criteria. RESULTS: Among the cohort of 806 cases, 520 (64.5%) had an identifiable embryo. One hundred fifty-nine of these embryos had no demonstrable heartbeat and a CRL of 5 mm or less. The CRLs of these embryos ranged from 1.7 to 5.4 mm. This cohort's sonograms were reviewed to determine whether there was a separation between the embryo and yolk sac. Twenty-one cases were discovered. Recall that as a retrospective study, no specific effort was made to show this finding. Thus, a computation of the sensitivity of this finding would result in an underestimate of indeterminate magnitude. All of these cases were subsequently proven to be failed pregnancies. CONCLUSIONS: The positive predictive value of the "yolk stalk sign" in determining early pregnancy failure for an embryo with a CRL of 5 mm or less and no visible heartbeat was 100% in this cohort.
Authors:
Marcus R Filly; Peter W Callen; N Tugce Yegul; Roy A Filly
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine     Volume:  29     ISSN:  1550-9613     ISO Abbreviation:  J Ultrasound Med     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-27     Completed Date:  2010-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211547     Medline TA:  J Ultrasound Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  237-41     Citation Subset:  IM    
Affiliation:
Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave, San Francisco, CA 94143-0628 USA. roy.filly@radiology.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Cardiotocography / utilization*
Extraembryonic Membranes / ultrasonography*
Female
Fetal Death / epidemiology*,  ultrasonography*
Heart Rate*
Humans
Male
Ohio / epidemiology
Reproducibility of Results
Sensitivity and Specificity
Ultrasonography, Prenatal / methods*,  utilization*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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