YOLK SAC MEASUREMENTS AND EMBRYONIC HEART RATE IN PREDICTING FIRST TRIMESTER PREGNANCY OUTCOME

Dr. Girdhari Lal Palsania; Dr. Purnima Pachori; Dr. Dharmendra

Volume : IX, Issue : VII, July - 2020

YOLK SAC MEASUREMENTS AND EMBRYONIC HEART RATE IN PREDICTING FIRST TRIMESTER PREGNANCY OUTCOME

Dr. Girdhari Lal Palsania, Dr. Purnima Pachori, Dr. Dharmendra

Abstract :

BACKGROUND : Yolk sac is the first ultrasonographically visible extra emyonic structure within the gestational sac. In Early pregnancy, threatened and spontaneous abortions is the most common complication. As per some studies, enlarged or small yolk sac predicts poor pregnancy outcome. Whereas other studies, they conclude normal outcome. OBJECTIVE : This study is conducted to assess the correlation of patient’s first trimester outcome (Normal continuation of pregnancy / Miscarriage) with the yolk sac size and the emyonic heart rate at 6‐12 wks gestation and to evaluate the association of patient’s age, consanguinity, menstrual history, parity and medical illness with first trimester outcome and to evaluate the other sonographic parameters like Crown Rump Length and mean sac diameter with first trimester outcome. MATERIALS AND METHODS : This prospective study was conducted at Rajkiya Mahila Chikitsalaya, JLN Medical College, Ajmer during Sep 2018 to Oct 2019. Antenatal women was included in the study belonging to first trimester. Women attending routine antenatal check up in the out–patient department was subjected to scan. Only those antenatal women who will <30 years and of singleton pregnancy was included in the study. The study was including both primigravida and multigravida. No socio–economic categorization was made. Patient with history of intake of teratogenic drugs, without emyonic heart rate, an emyonic pregnancy, subchorionic haemorrhage and inconsistency between gestational sac size and CRL was excluded from the study. RESULTS: In our study Gestational sac mean size was 32.12 and significantly correlates with the first trimester outcome (p=0.007**). It was 33.10 mm mean in the normal pregnancies and mean of 26.61mm in miscarriage group. Emyonic heart rate has found significant correlation with the first trimester outcome (p=0.048*). The ultrasonographic estimation of gestational age has found significant correlation with pregnancy outcome (p<0.001**). In our study Crown rump length inversely associated with miscarriage (p=0.044*). CONCLUSION : Yolk sac size and characteristics are important determinants of outcome of pregnancy. This should be monitored in early pregnancy to assess the outcome of pregnancy. The present study indicates that the yolk sac size and the emyonic heart rate is a reliable, cost effective and beneficial in predicting first trimester pregnancy outcome especially in patients who conceive following IVF.