Evaluation of the Use of Absent Yolk Sac Sign and Fetal Bradycardia as Markers for Early Fetal Demise
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- Category: Vol. 77, December 2009
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Evaluation of the Use of Absent Yolk Sac Sign and Fetal Bradycardia as Markers for Early Fetal Demise, ABDALLA Y. EL KATEB
Abstract
Objective: To evaluate the accuracy of ultrasound assess-ment of absent yolk sac or fetal bradycardia in prediction of early fetal demise.
Design: A cross sectional study.
Setting: Department of Obstetrics & Gynecology, Cairo University.
Participants: Two hundred forty eight pregnant women were scanned by trans-abdominal and/or trans-vaginal sonography in the first trimester for evaluation of the yolk sac and the fetal heart rate. Cases were followed up and evaluated for the outcome of the first trimester. Sensitivity, specificity, positive predictive value, negative predictive value, relative risks and accuracy were analyzed and calculated.
Results: Relative risk (RR) of abortion in cases with absent yolk sac alone was calculated and estimated to be 10.2 (95% CI = 5.8 to 17.7) while RR with fetal bradycardia alone was 7.4 (95% CI 3.9 to 13.98). Interestingly, when both signs were combined, RR has much better confidence interval and was found to be 10.9 (95% CI = 7.2 to 16.6) and the accuracy of prediction was improved to 91.5%.
Conclusion: Fetal bradycardia and absent yolk sac partic-ularly when used in combination can be considered as possible tools for prediction of early fetal demise.