| The yolk stalk sign: evidence of death in small embryos without heartbeats. | |
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MedLine Citation:
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PMID: 20103794 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Marcus R Filly; Peter W Callen; N Tugce Yegul; Roy A Filly |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2010-01-27 Completed Date: 2010-05-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8211547 Medline TA: J Ultrasound Med Country: United States |
Other Details:
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Languages: eng Pagination: 237-41 Citation Subset: IM |
Affiliation:
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Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave, San Francisco, CA 94143-0628 USA. roy.filly@radiology.ucsf.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Cardiotocography
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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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