Ultrasonography and Pregnancy Outcome in Threatened Abortion: A Prospective Observational Study

Authors

  • Maya Singh Assistant Professor, Department of Obstetrics and Gynecology, Maharshi Devraha Baba Autonomous State Medical College, Deoria, Uttar Pradesh, India
  • Shishir Kumar Assistant Professor, Department of Radiodiagnosis, Maharshi Devraha Baba Autonomous State Medical College, Deoria, Uttar Pradesh, India
  • Nahid Lari Senior Resident, Department of Obstetrics and Gynecology, Maharshi Devraha Baba Autonomous State Medical College, Deoria, Uttar Pradesh, India
  • Daya Shankar  Assistant Professor, Department of Otorhinolaryngology, KMC Medical College and Hospital, Maharajganj, Uttar Pradesh, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i3.1660

Keywords:

First-trimester ultrasound, fetal heart rate, crown-rump length, pregnancy outcomes, preterm birth, intrauterine growth restriction

Abstract

Background: Threatened abortion, marked by first-trimester vaginal bleeding, poses a risk for pregnancy loss and adverse outcomes. Ultrasonography is a key diagnostic tool for assessing fetal viability and identifying predictive markers such as fetal heart rate and crown-rump length. This study explores the role of ultrasonographic parameters in predicting miscarriage risk and guiding clinical management.

Methods: This prospective observational study encompassed 100 pregnant women categorized into three groups based on first-trimester bleeding and ultrasonographic findings. Transvaginal ultrasonography assessed fetal heart rate, cervical length, and gestational sac characteristics. Statistical analyses evaluated the predictive value of sonographic markers for pregnancy outcomes.

Results: Baseline characteristics were comparable among groups, but Group I had earlier and heavier bleeding. Group I also revealed lower fetal heart rates and crown-rump lengths, indicating poor pregnancy viability (p < 0.05). Adverse maternal and neonatal outcomes, including PROM, IUGR, and NICU admissions, were more frequent in Group II (p < 0.05). Early abnormal ultrasound markers were significantly associated with late pregnancy complications.

Conclusion: Early first-trimester ultrasound markers, particularly fetal heart rate and crown-rump length, are strong predictors of adverse pregnancy outcomes. Identifying these markers can aid in risk stratification and timely intervention.

References

M. R, G. A. A prospective observational study on pregnancy outcome in women with threatened miscarriage in a tertiary care centre. J Evol Med Dent Sci. 2021;10(45):4003–4008.

Mahadik K, Choudhary P, Roy PK. Study of thyroid function in pregnancy, its feto-maternal outcome; a prospective observational study. BMC Pregnancy Childbirth. 2020;20(1).

Badugu RB, Kodey P, Pappala S. Evaluation of outcome of pregnancy complicated with thrombocytopaenia: a prospective observational study. J Clin Diagn Res. 2022.

Rajendran, Parikh R. A prospective and observational study on fetomaternal outcome in postdated pregnancy. Int J Med Biomed Stud. 2020;4:10.

Ghosh M, Mandal AK, Seth S, Naskar A. Fetomaternal outcome in patients with threatened abortion in the first trimester – an observational study. Asian J Med Sci. 2022;13(3):152–157.

Sakran R, Shechtman S, Arnon J, Diav-Citrin O. Pregnancy outcome following in-utero exposure to ondansetron: a prospective comparative observational study. Reprod Toxicol. 2021;99:9–14.

Pleasant EA, Cartwright AF, Upadhyay UD. Association between distance to an abortion facility and abortion or pregnancy outcome among a prospective cohort of people seeking abortion online. JAMA Netw Open. 2022;5(5).

Kumari P, Wanjari S. Comparison of transvaginal colour Doppler ultrasound and progesterone level estimation in outcome of threatened abortion in early pregnancy. J Clin Diagn Res. 2020.

Acharya T, Gohain BS, Morang K. Pregnancy outcome in a bicornuate uterus with bilateral pregnancy presenting as threatened abortion: a case report. Int J Reprod Contracept Obstet Gynecol. 2021;10(11):4334.

Chowdhury DS. Successful pregnancy outcome after laparotomy (a case of pregnancy with ovarian tumour). J Med Sci Clin Res. 2020;08(02).

Lee SE, Bae YK. Breast lesions during pregnancy and lactation: a pictorial essay. Ultrasonography. 2020;39(3):298–310.

Bon GG, Kenemans P, Dekker JJ, Hompes PG, Verstraeten RA, et al. Fluctuations in CA 125 and CA 15–3 serum concentrations during spontaneous ovulatory cycles. Hum Reprod. 1999;14:566-570.

Leylek OA, Senocak F, Erselcan T. The prognostic predictive value of maternal serum CA 125 levels in threatened abortion. Int J Gynecol Obstet. 1997;59:147-149.

Datta MR, Raut A. Efficacy of first-trimester ultrasound parameters for prediction of early spontaneous abortion. Int J Gynecol Obstet. 2017;138:325-330.

Dede FS, Ulucay U, Kose MF, Dede H, Dilbaz S, et al. Fetal loss in threatened abortion after demonstration of fetal cardiac activity in a low socioeconomic population. J Obstet Gynecol. 2010;30:622-625.

Chitacharoen A, Herabutya Y. Slow fetal heart rate may predict pregnancy outcome in first-trimester threatened abortion. Fertil Steril. 2004;82:227-229.

Wie JH, Choe S, Kim SJ, Shin JC, Kwon JY, et al. Sonographic parameters for prediction of miscarriage: The role of 3-dimensional volume measurement. J Ultrasound Med. 2015;34:1777-1784.

Bamniya J, Panchal D, Singh P, Shah A, Ladola H, et al. Early sonographic markers and prediction of pregnancy outcome: a prospective study. Int J Reprod Contracept Obstet Gynecol. 2017;6:2471-2484.

Oh JS, Wright G, Coulam CB. Gestational sac diameter in very early pregnancy as a predictor of fetal outcome. Ultrasound Obstet Gynecol. 2002;20:267-299.

Tan S, Tangal NG, Kanat-Pektas M, Özcan AŞ, Keskin HL. Abnormal sonographic appearances of the yolk sac: which can be associated with adverse perinatal outcome? Med Ultrasonography. 2014;16:15-20.

Abuelghar WM, Fathi HM, Ellaithy MI, Anwar MA. Can a smaller than expected crown-rump length reliably predict the occurrence of subsequent miscarriage in a viable first-trimester pregnancy? J Obstet Gynecol Res. 2013;10:1449-1455.

Papaioannou GI, Syngelaki A, Maiz N, Ross JA, Nicolaides KH. Ultrasonographic prediction of early miscarriage. Hum Reprod. 2011;26:1685-1692.

Harlev A, Levy A, Zaulan Y, Koifman A, Mazor M, et al. Idiopathic bleeding during the second half of pregnancy as a risk factor for adverse perinatal outcome. J Matern Fetal Neonatal Med. 2008;21:331-335.

Riahinejad S, Motamedi N, Saadat N, Mostofiniya M, Toghiani A, et al. Effect of vaginal bleeding in the first trimester of pregnancy on pregnancy outcomes. J Isfahan. 2011;29.

Saraswat L, Bhattacharya S, Maheshwari A. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG Int J Obstet Gynecol. 2010;117:245-257.

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Published

2025-03-31

How to Cite

Singh, M. ., Kumar, S., Lari, N. ., & Shankar, D. . (2025). Ultrasonography and Pregnancy Outcome in Threatened Abortion: A Prospective Observational Study. Student’s Journal of Health Research Africa, 6(3), 8. https://doi.org/10.51168/sjhrafrica.v6i3.1660

Issue

Section

Section of Obstetrics and Gynecology Research