First‐trimester ultrasound features associated with subsequent miscarriage: A prospective study
Open accessAbstract
Background: First‐trimester miscarriage is common, with women increasingly offered an ultrasound scan early in the first trimester to assess the status of their pregnancy. Ultrasound is uniquely situated to significantly impact the clinical management of these women. Aims: This study aims to determine whether there were any differences in the early ultrasound appearances of pregnancies that continued to be viable or resulted in miscarriage before 12 weeks gestation. Materials and Methods: This was a prospective cohort study including ultrasound measurements: mean sac diameter ( MSD ), yolk sac diameter ( YSD ), crown‐rump length ( CRL ), fetal heart rate ( FHR ), trophoblast thickness, trophoblast volume (TTV) and mean uterine artery pulsatility index (mean UAPI ). Regression models were fitted for each parameter and Z‐scores compared between cohorts that progressed or miscarried after the scan but before 12 weeks gestation. Logistic regression analysis was used to create a prediction model for miscarriage prior to 12 weeks gestation based on the standardised ultrasound measurements recorded during the early first‐trimester scan. Results: Comparison of Z‐Scores for mean UAPI , TTV, FHR and MSD demonstrated significant variation between the two groups. The proposed logistic regression model resulted in an area under the receiver operator curve of 0.81. At a false‐positive rate of 30%, the model resulted in a sensitivity of 76% (95% CI 64–89%). Conclusion: The combination of FHR , mean UAPI , TTV in a prediction model for miscarriage may prove to be of value for ongoing pregnancy management in the first trimester.
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Sonographic findings in early pregnancy have prognostic value in predicting pregnancy outcomes.
“Several studies have demonstrated that sonographic findings in early pregnancy have prognostic value in predicting pregnancy outcomes.”
Most existing studies investigate the individual components of the first-trimester ultrasound for predicting miscarriage.
“Most existing studies investigate the individual components of the first-trimester ultrasound for predicting miscarriage [9, 25, 26].”
Cites
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61602-x · Cited by 21,320 · see citing works
von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Initiative, F. T. S. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-8-200710160-00010 · Cited by 17,796 · see citing works
Onset of Maternal Arterial Blood Flow and Placental Oxidative Stress
Jauniaux, E., Watson, A. L., Hempstock, J., Bao, Y.-P., Skepper, J. N., & Burton, G. J. (2000) · The American Journal of Pathology · doi:10.1016/s0002-9440(10)64849-3 · Cited by 1,057 · see citing works
Jauniaux, E., Hempstock, J., Greenwold, N., & Burton, G. J. (2003) · The American Journal of Pathology · doi:10.1016/s0002-9440(10)63803-5 · Cited by 511 · see citing works
Hustin, J., & Schaaps, J. (1987) · American Journal of Obstetrics and Gynecology · doi:10.1016/s0002-9378(87)80371-x · Cited by 343 · see citing works
Trends in Risk of Pregnancy Loss Among US Women, 1990–2011
Rossen, L. M., Ahrens, K. A., & Branum, A. M. (2017) · Paediatric and Perinatal Epidemiology · doi:10.1111/ppe.12417 · Cited by 215 · see citing works
Growth and development of the human fetus prior to the twentieth week of gestation
Hellman, L. M., Kobayashi, M., Fillisti, L. P., & Lavenhar, M. A. (1969) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(69)90575-4 · Cited by 133 · see citing works
Prediction of early pregnancy viability in the absence of an ultrasonically detectable embryo
Elson, J. C., Salim, R., Tailor, A., Banerjee, S., Zosmer, N., & Jurkovic, D. (2002) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.1 · Cited by 97 · see citing works
Ultrasonographic prediction of early miscarriage
Papaioannou, G. I., Syngelaki, A., Maiz, N., Ross, J. A., & Nicolaides, K. H. (2011) · Human Reproduction · doi:10.1093/humrep/der130 · Cited by 88 · see citing works
Placental Volume at 11–13 Weeks’ Gestation in the Prediction of Birth Weight Percentile
Plasencia, W., Akolekar, R., Dagklis, T., Veduta, A., & Nicolaides, K. H. (2011) · Fetal Diagnosis and Therapy · doi:10.1159/000324318 · Cited by 86 · 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
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
Odeh, M., Ophir, E., Maximovsky, O., Grinin, V., & Bornstein, J. (2011) · Prenatal Diagnosis · doi:10.1002/pd.2697 · Cited by 66 · see citing works
Association between first-trimester placental volume and birth weight
Effendi, M., Demers, S., Giguère, Y., Forest, J., Brassard, N., Girard, M., Gouin, K., & Bujold, E. (2013) · Placenta · doi:10.1016/j.placenta.2013.11.015 · Cited by 62 · see citing works
Anxiety associated with diagnostic uncertainty in early pregnancy
Richardson, A., Raine‐Fenning, N., Deb, S., Campbell, B. K., & Vedhara, K. (2016) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.17214 · Cited by 52 · see citing works
Reus, A. D., El-Harbachi, H., Rousian, M., Willemsen, S. P., Steegers-Theunissen, R. P. M., Steegers, E. A. P., & Exalto, N. (2013) · Ultrasound in Obstetrics & Gynecology · doi:10.1002/uog.13197 · Cited by 46 · see citing works
Comparison of Placental Volume in Early Pregnancy Using Multiplanar and VOCAL Methods
NOWAK, P. M., Nardozza, L. M. M., Júnior, E. A., Rôlo, L. C., & Moron, A. F. (2008) · Placenta · doi:10.1016/j.placenta.2007.12.003 · Cited by 43 · see citing works
Embryonic heart rate in early pregnancy
Stefos, T., Lolis, D. E., Sotiriadis, A., & Ziakas, G. (1998) · Journal of Clinical Ultrasound · doi:10.1002/(sici)1097-0096(199801)26:1 · Cited by 40 · see citing works
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
Cheong, K. B., Leung, K. Y., Chan, H. Y., Lee, Y. P., Yang, F., & Tang, M. H. Y. (2009) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.6255 · Cited by 32 · see citing works
Plasencia, W., Barber, M. Á., Álvarez, E. E., Segura, J., Valle, L., & García-Hernández, J. Á. (2010) · Hypertension in Pregnancy · doi:10.3109/10641955.2010.506232 · Cited by 32 · 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
Evaluation of Placental Volume at 7–10 + 6 Weeks of Pregnancy by 3D-Sonography
Nardozza, L. M. M., NOWAK, P. M., Júnior, E. A., Filho, H. A. G., Rôlo, L. C., Torloni, M. R., & Moron, A. F. (2009) · Placenta · doi:10.1016/j.placenta.2009.04.008 · Cited by 28 · see citing works
Construction of modern Australian first trimester ultrasound dating and growth charts
Mclennan, A., & Schlüter, P. J. (2008) · Journal of Medical Imaging and Radiation Oncology · doi:10.1111/j.1440-1673.2008.01992.x · Cited by 26 · see citing works
Pregnancy outcome after a first trimester sonogram demonstrating fetal cardiac activity
Frates, M. C., Benson, C. B., & Doubilet, P. M. (1993) · Journal of Ultrasound in Medicine · doi:10.7863/jum.1993.12.7.383 · Cited by 25 · see citing works
The value of the secondary yolk sac in predicting pregnancy outcome
Chama, C., Marupa, J., & Obed, J. Y. (2005) · Journal of Obstetrics and Gynaecology · doi:10.1080/01443610500060677 · Cited by 23 · 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
Bajo, J., Calvo, F. J. M., Martinez-Cortes, L., Palazuelos, F. J. H., & Rayward, J. (2000) · Human Reproduction · doi:10.1093/humrep/15.7.1629 · Cited by 16 · see citing works
Early Pregnancy: Normal and Abnormal
Goldstein, S. R. (2008) · Seminars in Reproductive Medicine · doi:10.1055/s-2008-1076146 · Cited by 12 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Wang, T. A., Kang, X., Zhao, A., He, L., Liu, Z., & Liu, F. (2020) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13160 · Cited by 30 · see citing works
Zhang, X., Guo, F., Wang, Q., Bai, W., & Zhao, A. (2021) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13838 · Cited by 24 · 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
Li, M., Zhou, R., Yu, D., Chen, D., & Zhao, A. (2024) · Human Reproduction · doi:10.1093/humrep/deae181 · Cited by 19 · see citing works
Guo, J., Feng, Q., Chaemsaithong, P., Appiah, K., Sahota, D. S., Leung, B. W., Chung, J. P. W., Li, T. C., & Poon, L. C. (2023) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.1111/aogs.14618 · Cited by 14 · see citing works
Hanchard, T. J., de Vries, B. S., Quinton, A. E., Sinosich, M. J., & Hyett, J. A. (2020) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.21962 · Cited by 11 · see citing works
Self-citationUse and misuse of ultrasound in obstetrics with reference to developing countries
Kurjak, A., Medjedović, E., & Stanojević, M. (2022) · Journal of Perinatal Medicine · doi:10.1515/jpm-2022-0438 · Cited by 8 · see citing works
Guo, J., Chaemsaithong, P., Huang, J. L., Chung, J. P. W., Huang, J., Poon, L. C., & Li, T. C. (2020) · International Journal of Gynecology & Obstetrics · doi:10.1002/ijgo.13371 · Cited by 7 · see citing works
Idelson, A., Meiri, H., Wertheimer, A., Sammar, M., Tenenbaum-Gavish, K., Shufaro, Y., & Ben‐Haroush, A. (2020) · Placenta · doi:10.1016/j.placenta.2020.07.030 · Cited by 4 · see citing works
Pollie, M., Romanski, P. A., Bortoletto, P. E., & Spandorfer, S. D. (2023) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2023.07.031 · Cited by 3 · see citing works
Sammut, L., Bezzina, P., Gibbs, V., & Calleja‐Agius, J. (2024) · Radiography · doi:10.1016/j.radi.2024.07.022 · Cited by 3 · see citing works
Liu, L., Zang, Y., Zheng, H., Li, S., Song, Y., Feng, X., Zhang, X., Li, Y., Cao, L., Zhou, G., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-11518-5 · Cited by 3 · see citing works
Lisova, K., Кalinovska, І. V., & Токар, П. Ю. (2022) · Wiadomości Lekarskie · doi:10.36740/wlek202201114 · Cited by 3 · see citing works
Leíble, S., Canals, A., Walton, R., Gabriel Mitelman, M., Castiglione, A., Biron, M., Faundez, R., & Sepúlveda, W. (2021) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2021.1932809 · Cited by 2 · see citing works
Wang, Y., Han, F., Chuanjie, L., Zhang, Q., Yin, C., Teng, Y., & Yuan, Z. (2026) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2026.3650981 · Cited by 1 · see citing works
Nancarrow, L., Tempest, N., Vinayagam, S., Lane, S., Drakeley, A., Homburg, R., Russell, R., & Hapangama, D. K. (2023) · Reproduction and Fertility · doi:10.1530/raf-23-0044 · Cited by 1 · see citing works
Timakina, D. N., & Bulanov, M. N. (2024) · Ultrasound & Functional Diagnostics · doi:10.24835/1607-0771-2023-4-67-95 · Cited by 1 · see citing works
Période embryonnaire et datation de la grossesse
Guérin, B., Robert, Y., & Bourgeot, P. (2021) · Elsevier eBooks · doi:10.1016/b978-2-294-76352-6.00004-1
Wang, Y., Zhang, Q., Yin, C., Teng, Y., Han, F., & Yuan, Z. (2022) · SSRN Electronic Journal · doi:10.2139/ssrn.4181708
Кравченко, О. В., & Solovei, V. M. (2022) · Neonatology surgery and perinatal medicine · doi:10.24061/2413-4260.xii.3.45.2022.3
Cao, Y., Chen, Y., Wang, G., Li, S., & Liu, Z. (2023) · Current Medical Imaging Formerly Current Medical Imaging Reviews · doi:10.2174/1573405620666230714122732
Timakina, D. N., Bulanov, M. N., & Efremov, V. A. (2024) · Ultrasound & Functional Diagnostics · doi:10.24835/1607-0771-272
Diagnosis and Management of Extrauterine Pregnancies
Braud, L. V. D., & Jurkovic, D. (2025) · Cambridge University Press eBooks · doi:10.1017/9781009532549.022
Farag, M. A., El-Dine, A. A. S., Bendary, A., & El-elemi, M. M. I. (2025) · Benha Medical Journal · doi:10.21608/bmfj.2025.376344.2372
Nguyen, N. T. T., Watch, L., Garrido, C. R., Bickett, A. N., Unnithan, S., Truong, T., Erkanli, A., & Neal, S. A. (2025) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2025.114759
Wang, Y., Zhang, Q., Yin, C., Chen, L., Yang, Z., Jia, S., Sun, X., Bai, Y., Han, F., & Yuan, Z. (2022) · Figshare · doi:10.6084/m9.figshare.20444224
Imtiaz, S. (2026) · Journal of Bahria University Medical and Dental College · doi:10.51985/jbumdc2025659
Role of ultrasound markers in predicting early pregnancy loss: a systematic review
Subramanian, A., & Serranito, A. (2026) · International Journal of Reproduction Contraception Obstetrics and Gynecology · doi:10.18203/2320-1770.ijrcog20261468
- Authors
- Taylor, T. J., Quinton, A. E., de Vries, B. S., & Hyett, J. A.
- Affiliations
- The University of Sydney (AU)
- Discipline of Obstetrics, Gynaecology and Neonatology Central Clinical School Faculty of Medicine University of Sydney Sydney New South Wales Australia
- Corresponding author
- Taylor, Tracey J.
- Venue
- Australian and New Zealand Journal of Obstetrics and Gynaecology
- Publisher
- Wiley
- Published
- 2019-02-06
- Volume
- 59
- Issue
- 5
- Pages
- 641-648
- ISSN
- 0004-8666 (ISSN-L)
- 1479-828X
- OpenAlex
- W2913371311
- Cited by
- 27
- References
- 29
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 3 · 2020: 4
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Australian and New Zealand Journal of Obstetrics and Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Acquire (CQUniversity) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- 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
- first-trimester miscarriage, first-trimester ultrasound, yolk sac diameter, crown-rump length, fetal heart rate, uterine artery pulsatility index
- MeSH terms
- Abortion, Spontaneous, Adult, Female, Heart Rate, Fetal, Humans, Predictive Value of Tests, Pregnancy, Pregnancy Trimester, First, Prospective Studies, Pulsatile Flow, Cohort Studies, Ultrasonography, Prenatal, Crown-Rump Length, Uterine Artery
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