Prediction of Pregnancy Prognosis with the help of First Trimester Ultrasound Screening

Introduction: Spontaneous miscarriage is involuntary termination of pregnancy before 20th week of gestation or spontaneous expulsion of fetus below fetal weight of 500 gram. Approximately 12-24% of all pregnancies suffer miscarriages and most of the early miscarriages are caused by chromosomal abnormalities, and the risk of which increases with maternal age. Antenatal ultrasonography (USG) has revolutionized the management of early pregnancy failure. First trimester of pregnancy is the most important period of human development in which single cell transforms into a recognizable human being. USG plays an important role in assessing establishment and evaluation of early pregnancy. It also helps in diagnosing any untoward events in early pregnancy and may guide its appropriate management. Therefore, USG is an easily available tool to differentiate normal from abnormal pregnancy. Aim: 1. To assess early pregnancy developmental changes in 1st trimester USG. 2. To co-relate abnormal ultrasound findings with clinical outcome, measured in terms of spontaneous or missed abortion. Objective: To identify abnormal ultrasound parameters and co-relate USG findings with clinical outcome. Method: This retrospective observation study carried was out in Department of obstetrics and gynecology at Sardar Vallabhbhai Patel (SVP) Hospital, enrolling 120 pregnant women with estimated gestational of 5 to 12 weeks who had attended outpatient department, fulfilling inclusion and exclusion criteria. Results: In our study out of 120 patients 20% suffered abortion, 8% were born preterm. 44% of patients belonged to age group of 21-25yr age group, majority being multigravida i.e. 55%, of which 62.5% suffered abortion. Those with past history of abortion 56% of them suffered from abortion again especially with less than 8 weeks of gestation. Yolk sac diameter >6mm and RI >0.5 were the leading predictors of abortion. Conclusion: The findings suggest that it is possible to predict the outcome of pregnancies based on USG findings. USG findings like abnormal yolk sac size (more than 6mm), mean sac diameter more than 25mm with yolk sac but without embryo, mean sac diameter – crown rump length less than 5mm, crown rump length >9mm with no cardiac activity, embryonic fetal heart rate <100/min, resistive index of spiral arteries >0.55 and intra-uterine hematoma- all have positive predictive value and results are statistically significant to predict early pregnancy failure.