A Hospital Based Prospective Study to Assess the Correlation of First Trimester Pregnancy Outcome Using Yolk Sac Measurements and Embryonic Heart Rate at Newly Established Tertiary Care Centre

Abstract

Background: Ultrasound is the primary imaging modality in obstetrics over the last three decades. The advent of high-resolution transvaginal ultrasound (TVS) has revolutionized our understanding of the pathophysiology and the management of early pregnancy failure. This prospective correlation study is conducted to assess the correlation of first trimester pregnancy outcome using yolk sac measurements and embryonic heart rate. Materials & Methods: This is a prospective study done on 80 women attending routine antenatal check up in the out-patient department of gynecology were subjected to scan at Government Medical College, Pali, Rajasthan, India. A thorough general, physical, systematic and obstetric examination was carried out. After obtaining informed consent the women between 6-12 weeks of gestation were subjected to transvaginal ultrasound (using linear array real time B scan with 7.5 MHz transducer). The chi-square test and student paired t test were used for qualitative data. A P value of <.05 indicated statistical significance. Data were analyzed using SPSS (v 22.0; IBM).Results: Our study showed that age at the time of pregnancy and first Sonogram correlates with the first trimester pregnancy outcome. Mean age was 23.38 years with minimum 16 years and maximum of 36 years. There was a linear correlation (p=0.026*) between the age at time of pregnancy and miscarriage. The Yolk sac size varied between 2.5 to 7.0 with a mean of 4.725 mm. The Yolk sac size has significant correlation with the first trimester pregnancy outcome. (T-test p=0.001**). The heart rate of the fetus ranged between 100 and 180, with a mean of 153.86. The heart rate of the fetus predicted the first trimester pregnancy outcome significantly (T-test p=0.035*). The area under the curve was 0.708. Yolk sac (mm) has at least one tie between the positive actual state group and the negative actual state group. Statistics may be biased. Conclusion: We concluded that the yolk sac size and the embryonic heart rate is a reliable, cost effective and beneficial in predicting first trimester pregnancy outcome especially in patients who conceive following IVF.