Ultrasonographic Estimation of Gestational Sac Diameter in Normal Pregnancy, Missed Abortion and Blighted Ovum in Early Pregnancy and Its Sequel
Background: Missed abortion and blighted ovum are associated with maternal morbidity
and mortality, so early and accurate diagnosis means early management and less
Objective: To compare gestational sac size between normal pregnancy and missed
abortion and blighted ovum to determine at what gestational age differences in gestational
sac size become evident. Also, to see whether it is possible that we can use it as a
parameter to differentiate between normal and abnormal pregnancies, especially at early
stages, when diagnosis of failed pregnancies can be difficult.
Methods: A prospective observational study at Department of Gynecology and Obstetrics
at Al-Yarmouk Teaching Hospital for a period of one year from the first May 2015 to the
first of May 2016 on 113 women with early pregnancy were included in this study. Two
dimensional abdominal ultrasound of the gestational sac size was done and follow up
weekly starting at 6 week until 9+6 weeks by serial ultrasound measurement of the sac
size and its sequel, and comparison was made between the subgroups (normal early
pregnancy, missed abortion, blighted ovum).
Results: There were 56 normal early pregnancies 46 missed abortions and 11 blighted
ovum. Gestational sac size was significantly larger in normal pregnancies compared to
missed abortion and blighted ovum, this difference started at 7 week between normal
pregnancy and missed abortion: 23.3±2.2 cm2 and 20.5±3.2 cm2, respectively (p < 0.001),
and 8 week between normal pregnancy and blighted ovum: 30.9±2 cm2 and 26.4±3.5 cm2,
respectively (p < 0.001). And the differences keep increasing during the ninth and tenth
weeks of gestation.
Conclusion: Gestational sac size in missed abortion and anembryonic pregnancies is
significantly smaller than in normal pregnancies, starting at 7 weeks for missed abortion
and 8 weeks for blighted ovum.
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