Ultrasonographic prediction of early miscarriage
Open accessAbstract
BACKGROUND: The aim of this retrospective study was to assess the value of maternal history and ultrasound scan findings at 6-10 weeks for predicting early miscarriage. METHODS: Embryonic crown-rump length (CRL), heart rate (HR), gestational sac diameter (GSD) and yolk sac diameter (YSD) were compared in two groups of women with singleton pregnancies attending an early pregnancy unit. In the first group the initial scan demonstrated a live embryo but in a subsequent visit the scan showed a dead embryo, complete or incomplete miscarriage. In the second group with a live embryo there was subsequent live birth of a normal neonate. RESULTS: There were 729 pregnancies with miscarriage and 4698 with normal outcome. Logistic regression analysis demonstrated that in the prediction of miscarriage the risk was higher in women of African racial origin [odds ratio (OR) 1.62], cigarette smokers (OR 1.91) and those with vaginal bleeding (OR 2.03) and increased with maternal age (OR 1.05) and YSD (OR 1.88) and was inversely related to CRL (OR 0.79), HR (OR 0.96) and GSD (OR 0.84). At false-positive rate of 30%, the detection rate of miscarriage in screening by vaginal bleeding was 45%, 53% by the addition of maternal history factors and 85.7% by the addition of ultrasound findings. CONCLUSIONS: In early pregnancy a prediction of miscarriage can be provided by a combination of maternal characteristics and ultrasound findings and the estimated risk can be used to rationalize follow-up. Our multivariate model requires prospective evaluation in a new sample population.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The text we found for this paper looks like another document, so the self-check wasn’t run.
Cites
Maternal age and fetal loss: population based register linkage study
Andersen, A.-M. N. (2000) · BMJ · doi:10.1136/bmj.320.7251.1708 · Cited by 1,690 · see citing works
A CRITICAL EVALUATION OF SONAR “CROWN‐RUMP LENGTH” MEASUREMENTS
Robinson, H. P., & Fleming, J. E. E. (1975) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1975.tb00710.x · Cited by 1,413 · see citing works
Racial/ethnic disparities in obstetric outcomes and care: prevalence and determinants
Bryant, A., Worjoloh, A., Caughey, A. B., & Washington, A. E. (2010) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2009.10.864 · Cited by 655 · see citing works
Metwally, M., Ong, K. J., Ledger, W. L., & Li, T. C. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.07.1290 · Cited by 539 · see citing works
Maternal risk factors for hypertensive disorders in pregnancy: a multivariate approach
Poon, L. C., Kametas, N. A., Chelemen, T., Leal, A., & Nicolaides, K. H. (2009) · Journal of Human Hypertension · doi:10.1038/jhh.2009.45 · Cited by 332 · see citing works
Self-citationCocaine and Tobacco Use and the Risk of Spontaneous Abortion
Ness, R. B., Grisso, J. A., Hirschinger, N., Marković, N., Shaw, L. M. J., Day, N. L., & Kline, J. K. (1999) · New England Journal of Medicine · doi:10.1056/nejm199902043400501 · Cited by 322 · see citing works
Çelik, E., To, M. S., Gajewska, K., Smith, G. C. S., & Nicolaides, K. H. (2008) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.5333 · Cited by 238 · see citing works
Self-citationResnik, R. R. (2003) · Obstetrics and Gynecology · doi:10.1097/00006250-200310000-00002 · Cited by 201 · see citing works
Osawa, H., & Mori, Y. (1996) · Journal of Clinical Ultrasound · doi:10.1002/(sici)1097-0096(199601)24:1 · Cited by 176 · see citing works
Management of women referred to early pregnancy assessment unit: care and cost effectiveness
Bigrigg, M. A., & Read, M. D. (1991) · BMJ · doi:10.1136/bmj.302.6776.577 · Cited by 156 · see citing works
INCREASED SERUM FERRITIN LEVELS IN ADULT STILL'S DISEASE
Ota, T., Higashi, S., SUZUKI, H., et al. (1987) · The Lancet · doi:10.1016/s0140-6736(87)90204-2 · Cited by 145 · see citing works
Association Between First-Trimester Vaginal Bleeding and Miscarriage
Hasan, R., Baird, D. D., Herring, A. H., Olshan, A. F., Funk, M. L. J., & Hartmann, K. E. (2009) · Obstetrics and Gynecology · doi:10.1097/aog.0b013e3181b79796 · Cited by 141 · see citing works
Age-related decline in fertility: A link to degenerative oocytes?
Lim, A. S. T., & Tsakok, M. F. H. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)81513-0 · Cited by 139 · see citing works
Meiotic errors in human oogenesis and spermatogenesis
Martin, R. H. (2008) · Reproductive BioMedicine Online · doi:10.1016/s1472-6483(10)60459-2 · Cited by 115 · see citing works
Poon, L. C. Y., Karagiannis, G., Staboulidou, I., Shafiei, A., & Nicolaides, K. H. (2011) · Prenatal Diagnosis · doi:10.1002/pd.2520 · Cited by 115 · see citing works
Self-citationBlohm, F., Fridén, B. E., & Milsom, I. (2007) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2007.01426.x · Cited by 111 · see citing works
Falco, P., Milano, V. N., Pilu, G., et al. (1996) · Ultrasound in Obstetrics and Gynecology · doi:10.1046/j.1469-0705.1996.07030165.x · Cited by 110 · see citing works
Fetal loss following ultrasound diagnosis of a live fetus at 6–10 weeks of gestation
Makrydimas, G., Sebire, N. J., Lolis, D., Vlassis, N., & Nicolaides, K. H. (2003) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.204 · Cited by 108 · see citing works
Self-citationSimpson, J. L. (2007) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0b013e31802f11f6 · Cited by 106 · see citing works
“GESTATION SAC” VOLUMES AS DETERMINED BY SONAR IN THE FIRST TRIMESTER OF PREGNANCY
Robinson, H. P. (1975) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1975.tb02205.x · Cited by 95 · see citing works
Papaioannou, G. I., Syngelaki, A., Poon, L. C., Ross, J. A., & Nicolaides, K. H. (2010) · Fetal Diagnosis and Therapy · doi:10.1159/000319589 · Cited by 92 · see citing works
Self-citationMukri, F., Bourne, T., Bottomley, C., Schoeb, C., Kirk, E., & Papageorghiou, A. T. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01833.x · Cited by 83 · see citing works
Embryonic heart activity: appearance and development in early human pregnancy
Schats, R., Jansen, C. A. M., & Wladimiroff, J. W. (1990) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1990.tb02469.x · Cited by 82 · see citing works
Aliyu, M. H., Lynch, O., Wilson, R. E., Alio, A. P., Kristensen, S., Marty, P. J., Whiteman, V. E., & Salihu, H. M. (2011) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-010-1447-8 · Cited by 81 · see citing works
Development of the secondary human yolk sac: correlation of sonographic and anatomical features
Jauniaux, E. R. M., Jurkovic, D., Henriet, Y., Rodesch, F., & Hustin, J. (1991) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137503 · Cited by 77 · see citing works
Reljič, M. (2001) · Ultrasound in Obstetrics & Gynecology · doi:10.1046/j.1469-0705.2001.00370.x · Cited by 71 · see citing works
Ultrasound prediction of risk of spontaneous miscarriage in live embryos from assisted conceptions
Choong, S., Rombauts, L. J. F., Ugoni, A. M., & Meagher, S. (2003) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.909 · Cited by 66 · see citing works
Ventura, S. J., Mosher, W. D., Curtin, S. C., Abma, J. C., & Henshaw, S. K. (1999) · PubMed · Cited by 65 · see citing works
Racial differences in C-reactive protein levels during normal pregnancy
Crockett, A. H., Jared, H., MOSS, K. L., Offenbacher, S., Beck, J. D., & Boggess, K. (2008) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2008.04.017 · Cited by 63 · see citing works
Embryonic heart rate in dated human embryos
Wisser, J., & Dirschedl, P. (1994) · Early Human Development · doi:10.1016/0378-3782(94)90152-x · Cited by 57 · see citing works
CHORIONIC BIOPSY AND MISCARRIAGE IN FIRST TRIMESTER
Gustavii, B. (1984) · The Lancet · doi:10.1016/s0140-6736(84)90955-3 · Cited by 52 · see citing works
Prognostic significance of the human yolk sac assessed by ultrasonography
Reece, E. A., Scioscia, A. L., Pinter, E., Hobbins, J. C., Green, J. L., Mahoney, M. J., & Naftolin, F. N. (1988) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(88)90445-0 · Cited by 49 · see citing works
The yolk sac in early pregnancy failure
Ferrazzi, E. M., Brambati, B., LANZANI, A., et al. (1988) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(88)90796-x · Cited by 47 · see citing works
Nazari, A., Check, J. H., Epstein, R. H., Dietterich, C., & Farzanfar, S. (1991) · PubMed · Cited by 47 · see citing works
Slow fetal heart rate may predict pregnancy outcome in first-trimester threatened abortion
Chittacharoen, A., & Herabutya, Y. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2003.12.026 · Cited by 40 · see citing works
First-trimester vaginal bleeding and the loss of chromosomally normal and abnormal conceptions
Strobino, B. A., & Pantel-Silverman, J. (1987) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(87)80280-6 · Cited by 35 · see citing works
Early Pregnancy Assessment Units
Edey, K. A., Draycott, T. J., & Akande, V. A. (2007) · Clinical Obstetrics & Gynecology · doi:10.1097/grf.0b013e3180305ef4 · Cited by 31 · see citing works
Dickey, R. P., Gasser, R. F., Olar, T. T., et al. (1994) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a138510 · Cited by 28 · see citing works
Jenkins, L. D., Powers, R. W., Cooper, M., et al. (2008) · Reproductive Sciences · doi:10.1177/1933719108316984 · Cited by 26 · see citing works
Dickey, R. P., Gasser, R. F., Olar, T. T., et al. (1994) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a138544 · Cited by 24 · see citing works
Enough is enough! Time for a new model of care for women with early pregnancy complications
Condous, G. S. (2008) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/j.1479-828x.2007.00820.x · Cited by 16 · see citing works
Prediction of First‐Trimester Miscarriage from Embryonic Bradycardia and Embryonic Growth Delay
Ikegawa, A. (1995) · Journal of Obstetrics and Gynaecology · doi:10.1111/j.1447-0756.1995.tb00909.x · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Yi, Y., Lu, G., Ouyang, Y., lin, G., Gong, F., & Li, X. (2016) · Reproductive Biology and Endocrinology · doi:10.1186/s12958-016-0147-z · Cited by 38 · see citing works
Stamatopoulos, N., Lu, C., Casikar, I., Reid, S., Mongelli, M., Hardy, N., & Condous, G. (2015) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/ajo.12395 · Cited by 31 · see citing works
First‐trimester ultrasound features associated with subsequent miscarriage: A prospective study
Taylor, T. J., Quinton, A. E., de Vries, B. S., & Hyett, J. A. (2019) · Australian and New Zealand Journal of Obstetrics and Gynaecology · doi:10.1111/ajo.12944 · Cited by 27 · see citing works
Triple ultrasound markers including fetal cardiac activity are related to miscarriage risk
Bae, S., & Karnitis, J. (2011) · Fertility and Sterility · doi:10.1016/j.fertnstert.2011.08.009 · Cited by 26 · see citing works
Wang, Y., Zhang, Q., Yin, C., Chen, L., Yang, Z., Jia, S., Sun, X., Bai, Y., Han, F., & Yuan, Z. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04936-0 · Cited by 19 · see citing works
Sonographic Parameters for Prediction of Miscarriage: Role of 3‐Dimensional Volume Measurement
Wie, J. H., Choe, S., Kim, S. J., Shin, J. C., Kwon, J. Y., & Park, I. Y. (2015) · Journal of Ultrasound in Medicine · doi:10.7863/ultra.15.14.09012 · Cited by 17 · see citing works
- Authors
- Papaioannou, G. I., Syngelaki, A., Maiz, N., Ross, J. A., & Nicolaides, K. H.
- Affiliations
- Harris Birthright Research Centre for Fetal Medicine (GB)
- King's College Hospital (GB)
- University College Hospital (GB)
- Corresponding author
- Nicolaides, K. H.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-04-30
- Volume
- 26
- Issue
- 7
- Pages
- 1685-1692
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2110737651
- Cited by
- 88
- References
- 42
- Citations by year
- 2025: 6 · 2024: 6 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 11 · 2019: 7 · 2018: 11 · 2017: 7 · 2016: 5 · 2015: 4 · 2014: 5 · 2013: 6 · 2012: 2
- FWCI
- 4.71
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- other-oa
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Screening and Diagnostics
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Keywords
- early pregnancy loss, pregnancy loss prediction, first-trimester ultrasound, crown-rump length, fetal heart rate, gestational sac diameter, yolk sac diameter, vaginal bleeding, maternal risk factors, cigarette smoking, maternal age, singleton pregnancy
- MeSH terms
- Abortion, Spontaneous, Abortion, Incomplete, Adult, Female, Heart Rate, Fetal, Humans, Maternal Age, Pregnancy, Pregnancy Trimester, First, Regression Analysis, Retrospective Studies, Yolk Sac, Ultrasonography, Prenatal, Crown-Rump Length, Black People, White People, Asian People, Gestational Sac
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review