الفهرس 
First trimester of pregnancyOnly 14 pages are availabe for public view
 |  | from | 63 |  |  |
| | | from | 63 | | |
Abstract
The early first trimester of pregnancy is the fragile period for pregnancy viability, with up to 50% of embryos being lost before the pregnancy is clinically detected, and up to 15% to 25% of clinical pregnancies spontaneously aborting.
The various modalities of predicting the pregnancy outcome in the first trimester include the imaging transvaginal ultrasound (TVS) and biochemical markers such as beta HCG.
However intrauterine gestational sac is the first one to appear sonographically, followed by the yolk sac and the foetal pole with cardiac activity. Within the gestational sac, yolk sac is the first evident embryonic structure. It is usually visible between the fifth and twelfth week of pregnancy as a round anechoic area; after which it undergoes degeneration.
As pregnancy with normal yolk sac advances in the first trimester, the frequency of complications reduces. The sensitivity of predicting normal outcome with regular yolk sac is as high as 94.2%.
Fetal heart activity is the earliest proof of a viable pregnancy and it has been documented in utero by TVS as early as 36 days’ menstrual age, approximately at the time when the heart tube starts to beat.
A continuous decline of EHR activity might inevitably be associated with miscarriage. Several previous studies have associated severe embryonic bradycardia with subsequent fetal loss.
By the appearance of these structures and their measurement we can predict the outcome of pregnancy to a large extent. Numerous sonographic signs of predictors of poor outcome have been described by various authors, including an excessively large, excessively small, or irregularly shaped gestational sac, a low implantation site, a large or irregular yolk sac, a weak decidual reaction, and a slow embryonic heart rate.
This study was designed to evaluate the correlation between each of the ultrasound parameters that were assessed in the first trimester (the gestational sac size, yolk sac size and shape and embryonic heart rate) to early pregnancy loss and the correlation between different ultrasound parameters to each other.
This randomized prospective controlled study included 250 pregnant females with singleton pregnancy during the first trimester from (6 to 8) weeks recruited after fulfilling criteria of inclusion at the Department of Obstetric and Gynecology at the faculty of medicine, Menoufia University and Kotour central hospital and excluding those with any uterine pathology as myomas or malformations, chronic diseases as (SLE, hypertension ,diabetes and cardiac diseases), and those with recurrent fetal loss.
Results:
The mean maternal age was 25.23 ± 5.37, ranged 17 - 39. The mean gestational age was 8.37 ± 2.46, ranged 4 - 13.50 cases (20%) had early pregnancy loss at the end of first trimester, but 200 cases (80%) didn’t have.
The mean Embryo crown rump length (cm) in those with early pregnancy loss at the end of first trimester was 1.61 ± 0.56, with range 0.71 – 2.04, while it was 3.16