The Value of Yolk Sac Diameter at Vaginal Ultrasonography as a Predictor of the First Trimester Pregnancy Outcome

Objective: The aim of this work was to determine the value of using ultrasonographic measurement of both yolk sac diameter and gestational sac diameter in the first trimester for prediction of pregnancy outcome. Subjects and Methods: This prospective observational study included 100 pregnant females in their first trimester of singleton pregnancy with no medical diseases. All women were examined by vaginal ultrasound during the 6 week of gestation to measure yolk sac diameter (YSD) and gestational sac diameter (GSD). During the 13 week of gestation, abdominal ultrasound was done to remeasure the sacs and confirm fetal well-being. This examination was the cutoff point of success of pregnancy. Results: The YS was measurable in 72 cases, absent in 16 cases and bandshaped in 2 cases. The latter 2 cases are combined with cases of absent YS in one group. YSD had good positive correlation with GSD (r = 0.709, p< 0.001) and GA (r = 0.646, p< 0.001). The outcome at the 13 week was normal in 74 women and abnormal in 26. Absence of the yolk sac was significantly associated with abnormal outcome (Odds Ratio (OR): 10.3, 95% CI: 5.3-19.8). Cases with abnormal outcome had significantly smaller yolk sacs and YSD/GSD ratio. YSD ≤ 3.1 mm predicts abnormal outcome with a sensitivity of 75% and specificity of 63.5%, while YSD/GSD ratio ≤ 0.2 shows the absolute sensitivity and specificity (100%). YSD/GA ≤ 0.065 predicts abnormal outcome with 100% sensitivity and specificity.Conclusion: Measurement of yolk sac diameter is a good predictor of bad neonatal outcome especially as a ratio to gestational sac diameter. [khaled S. Mousa, Amr Mohamed ElHelaly and Mahmoud Abd El-Aziz. The Value of Yolk Sac Diameter at Vaginal Ultrasonography as a Predictor of the First Trimester Pregnancy Outcome. Life Sci J 2014;11(1):236240]. (ISSN:1097-8135). http://www.lifesciencesite.com. 35

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