Korean J Obstet Gynecol.
1999 Jun;42(6):1183-1186.
Embryo and Amniotic Sac in Transvaginal Sonographic Diagnosis of Abortion
Abstract
OBJECTIVE
To minimize the side effects of intrauterine pregnancy at an early stage of intrauterine pregnancy in which an embryo can not be maintained, by early diagnosis and prompt operation.
METHODS
Pregnant patients, who had conditions that amniotic sac and embryo were observed with transvaginal sonography, and embryo was not in fetal cardiac activities in early pregnancy, as subject. Follow-up study was carried out prospectively on about 54 cases[GroupI] that were difficult to get diagnosis of abortion objectively with G-sac size and other conditions although CRL was 5mm or below and no cardiac activities. The patients were explained that the possibility of abortion was almost 100% if CRL was 6-7mm or G-sac size corresponded to being 7 weeks pregnant, and suggested that they should choose between immediate D&E or waiting one more week. When CRL was 8mm or more and G-sac size corresponded to being 8 weeks or more pregnant, or when it is certain of diagnosis the condition as spontaneous abortion without further follow-up study due to the fact that in previous transvaginal sonography, an embryo was in cardiac activities but presently not, immediate D&E was suggested. Among the 70 cases[GroupII] that got diagnosis of abortion with only one examination, D&E was done on 55 cases immediately and follow-up study was carried out with 15 cases because pregnant patients wanted to wait more.
RESULTS
Out of all 124 cases of pregnant patients, follow-up study was carried out GroupI from 1 day to 3 weeks and 5 cases had profuse vaginal bleeding. Out of this 5, 4 had emergency D&E for incomplete abortion and 1 had complete abortion. The rest of the patients were confirmed of abortion through follow-up study. In GroupII, among 15 cases that we did follow-up study because the pregnant patients wanted to wait some more, 2 cases had profuse vaginal bleeding and operated emergency D&E, and all the rest were diagnosed to have an abortion by re-examination.
CONCLUSION
In case of intrauterine pregnancy, if amniotic sac is observed in G-sac and there is an embryo that does not have cardiac activities, it seems to be better to proceed with D&E immediately without waiting.
