Lucky777
Mommy of 1 little boy
- Joined
- May 19, 2010
- Messages
- 628
- Reaction score
- 0
According to a 2008 study published in the journal, Obstetrics & Gynecology, miscarriage risk falls rapidly with advancing gestation. The researchers studied miscarriage rates of 697 women and found that the risk of miscarriage at 6 weeks gestation was 9.4%. At 7 weeks gestation, the risk of miscarriage fell to 4.2%, and at 8 weeks of gestation, it fell to 1.5%. The overall miscarriage rate for this group of women was 1.6% (11 of the 697 women miscarried at some point during their pregnancies).
This study involved women who did not have any symptoms of miscarriage when they were first enrolled in the study, and where evidence of fetal heartbeat was seen via ultrasound during their first prenatal visit (the first visit took place between week 6 and week 11 gestation).
So, if you have seen a fetal heartbeat on the ultrasound, and if you are not experiencing any symptoms of a miscarriage (i.e. heavy cramping, bleeding), then your risk of miscarriage is likely to be similar to the women in this study.
MAUI, HAWAII -- Women eager to conceive often want a fetal ultrasound in the first trimester to help gauge the viability of their pregnancy, and they're willing to pay for it, Dr. Bill Yee said at a conference on ob.gyn. ultrasound sponsored by the University of California, Irvine.
Bleeding or spotting in early pregnancy raises the fear of miscarriage. Among the older, infertile women seen by Dr. Yee, director of the in vitro fertilization program at Long Beach (Calif.) Memorial Medical Center, 40%-45% have some bleeding in the first trimester.
"I deal with very anxious patients," he said, adding that even those who don't have spotting often want ultrasound very early in their pregnancy.
For these patients, Dr. Yee recommended looking for the following sonographic signs to evaluate the pregnancy:
Four weeks' gestation. The first sonographic sign of pregnancy is a very echogenic endometrium that's usually about 10-12 mm thick. In the absence of other indicators, however, this is not a reliable sign of pregnancy.
Between 4.5 and 5 weeks' gestation in intrauterine pregnancies, real-time ultrasound or color Doppler ultrasound will show intervillous blood flow, which denotes blood shunting from the maternal sinusoid and spiral arteries into the lacunar network. This marker, which is found only in intrauterine pregnancies, is used to rule out ectopic pregnancy Dr. Yee said at the meeting, also sponsored by Long Beach Memorial Medical Center.
Five weeks' gestation. The first definitive ultrasound finding of an early intrauterine pregnancy appears consistently in the fifth week of gestation: a circular chorionic sac, typically 5-8 mm wide. As the pregnancy progresses, the sac elongates into an oval shape.
A 5- to 8-mm chorionic sac seen earlier than 5 weeks' gestation probably represents inaccurate dating or a shortened follicular phase resulting from earlier ovulation.
(The chorionic sac is sometimes called the gestational sac, but the latter term applies only to pregnancies after the amnion fuses with the chorion later in the first trimester, Dr. Yee noted.)
A chorionic sac that is smaller than 5 mm at 5 weeks' gestation could be the first sign of abnormal gestational development.
By week 5 or in women with an HCG level of 1,200 mIU/mL, the chorionic sac should be visible in 95% of cases. If it can't be seen, the patient may have an abnormal intrauterine pregnancy or an ectopic pregnancy and should be reexamined by ultrasound in 4-7 days.
Early detection of the circular yolk sac at the start of the fifth week is reassuring and may suggest a higher probability of a normal pregnancy, Dr. Yee said. An abnormally large yolk sac--larger than 6 mm by weeks 5-7--carries a high probability of miscarriage.
The secondary yolk sac can be seen in 50% of intrauterine pregnancies at 5 weeks' gestation, in 95% by 5.5 weeks, and in all cases when the chorionic sac is at least 8 mm.
The secondary yolk sac is indicated by the first echogenic lines within the chorionic sac. The primary yolk sac contains no fluid and cannot be seen on ultrasound, Dr. Yee commented.
Six weeks' gestation. Real-time ultrasound should identify embryonic cardiac activity by the sixth week of gestation. Heart rates that are slower than 120 beats per minute or that speed up or slow down could signal trouble, he warned.
The chorionic sac should measure about 16 mm; a sac of that size with no heartbeat "is not a good sign," he said.
A study of 316 singleton pregnancies in women with a history of infertility found a miscarriage rate of about 20% when the chorionic sac was seen at 5 weeks' gestation. At 6 weeks, the miscarriage rate dropped to 7% if cardiac activity was identified but climbed to 30% if cardiac activity was not evident.
Seven to 8 weeks' gestation. Accurate embryo pole measurements begin at week 7 and typically measure 9-11 mm, not including the umbilical cord. A normally developing pregnancy at 8 weeks' gestation, signified by an embryo length of 15-17 mm, has a 97% chance of a live delivery.
This study involved women who did not have any symptoms of miscarriage when they were first enrolled in the study, and where evidence of fetal heartbeat was seen via ultrasound during their first prenatal visit (the first visit took place between week 6 and week 11 gestation).
So, if you have seen a fetal heartbeat on the ultrasound, and if you are not experiencing any symptoms of a miscarriage (i.e. heavy cramping, bleeding), then your risk of miscarriage is likely to be similar to the women in this study.
MAUI, HAWAII -- Women eager to conceive often want a fetal ultrasound in the first trimester to help gauge the viability of their pregnancy, and they're willing to pay for it, Dr. Bill Yee said at a conference on ob.gyn. ultrasound sponsored by the University of California, Irvine.
Bleeding or spotting in early pregnancy raises the fear of miscarriage. Among the older, infertile women seen by Dr. Yee, director of the in vitro fertilization program at Long Beach (Calif.) Memorial Medical Center, 40%-45% have some bleeding in the first trimester.
"I deal with very anxious patients," he said, adding that even those who don't have spotting often want ultrasound very early in their pregnancy.
For these patients, Dr. Yee recommended looking for the following sonographic signs to evaluate the pregnancy:
Four weeks' gestation. The first sonographic sign of pregnancy is a very echogenic endometrium that's usually about 10-12 mm thick. In the absence of other indicators, however, this is not a reliable sign of pregnancy.
Between 4.5 and 5 weeks' gestation in intrauterine pregnancies, real-time ultrasound or color Doppler ultrasound will show intervillous blood flow, which denotes blood shunting from the maternal sinusoid and spiral arteries into the lacunar network. This marker, which is found only in intrauterine pregnancies, is used to rule out ectopic pregnancy Dr. Yee said at the meeting, also sponsored by Long Beach Memorial Medical Center.
Five weeks' gestation. The first definitive ultrasound finding of an early intrauterine pregnancy appears consistently in the fifth week of gestation: a circular chorionic sac, typically 5-8 mm wide. As the pregnancy progresses, the sac elongates into an oval shape.
A 5- to 8-mm chorionic sac seen earlier than 5 weeks' gestation probably represents inaccurate dating or a shortened follicular phase resulting from earlier ovulation.
(The chorionic sac is sometimes called the gestational sac, but the latter term applies only to pregnancies after the amnion fuses with the chorion later in the first trimester, Dr. Yee noted.)
A chorionic sac that is smaller than 5 mm at 5 weeks' gestation could be the first sign of abnormal gestational development.
By week 5 or in women with an HCG level of 1,200 mIU/mL, the chorionic sac should be visible in 95% of cases. If it can't be seen, the patient may have an abnormal intrauterine pregnancy or an ectopic pregnancy and should be reexamined by ultrasound in 4-7 days.
Early detection of the circular yolk sac at the start of the fifth week is reassuring and may suggest a higher probability of a normal pregnancy, Dr. Yee said. An abnormally large yolk sac--larger than 6 mm by weeks 5-7--carries a high probability of miscarriage.
The secondary yolk sac can be seen in 50% of intrauterine pregnancies at 5 weeks' gestation, in 95% by 5.5 weeks, and in all cases when the chorionic sac is at least 8 mm.
The secondary yolk sac is indicated by the first echogenic lines within the chorionic sac. The primary yolk sac contains no fluid and cannot be seen on ultrasound, Dr. Yee commented.
Six weeks' gestation. Real-time ultrasound should identify embryonic cardiac activity by the sixth week of gestation. Heart rates that are slower than 120 beats per minute or that speed up or slow down could signal trouble, he warned.
The chorionic sac should measure about 16 mm; a sac of that size with no heartbeat "is not a good sign," he said.
A study of 316 singleton pregnancies in women with a history of infertility found a miscarriage rate of about 20% when the chorionic sac was seen at 5 weeks' gestation. At 6 weeks, the miscarriage rate dropped to 7% if cardiac activity was identified but climbed to 30% if cardiac activity was not evident.
Seven to 8 weeks' gestation. Accurate embryo pole measurements begin at week 7 and typically measure 9-11 mm, not including the umbilical cord. A normally developing pregnancy at 8 weeks' gestation, signified by an embryo length of 15-17 mm, has a 97% chance of a live delivery.
