Cunningham D S, Bledsoe L D, Tichenor J R, Opsahl M S
Department of Obstetrics and Gynecology, National Naval Medical Center, Bethesda, Maryland, USA.
J Reprod Med. 1995 Aug;40(8):565-70.
To compile, for the first time, serial ultrasonographic findings during the first trimester of pregnancy in women with a history of primary recurrent spontaneous abortion so as to define the dynamics of early normal and abnormal gestations in this category of gravidas.
Transvaginal ultrasonograms were obtained weekly from 5 to 12 weeks' gestational age in 40 women, 10 each of four groups: recurrent spontaneous aborters and primiparas (controls), with both successful and failed gestations.
Embryonic heart motion was detected in 40-50% of successful pregnancies during the fifth week of gestation and in the balance by the sixth week, while heart motion was detected in no more than 50% of pregnancies that later failed. Of the failed pregnancies, all were evident by the eighth week of gestation, including those with previously documented viability. The gestational sac size and crown-rump length were smaller than expected in both failed groups, with the sac size difference evident as early as week 5 and the crown-rump length difference apparent by week 7.
Appropriate timing of the initial ultrasonogram in recurrent aborters (i.e., 8 weeks' gestational age) can identify, by means of heart motion and gestational sac features, all pregnancies that will ultimately fail.
首次汇编有原发性复发性自然流产病史女性在妊娠早期的系列超声检查结果，以明确这类孕妇早期正常和异常妊娠的动态变化。
对40名女性从妊娠5至12周每周进行经阴道超声检查，这40名女性分为四组，每组10人：复发性自然流产者和初产妇（对照组），包括妊娠成功和失败的情况。
在成功妊娠中，40% - 50%在妊娠第5周检测到胚胎心脏活动，其余在第6周检测到；而在后来失败的妊娠中，检测到心脏活动的不超过50%。在失败的妊娠中，所有在妊娠第8周时都已明显，包括那些先前记录有存活能力的妊娠。两组失败妊娠的妊娠囊大小和头臀长度均小于预期，妊娠囊大小差异早在第5周就明显，头臀长度差异在第7周明显。
复发性流产者初次超声检查的合适时机（即妊娠8周）可通过心脏活动和妊娠囊特征识别所有最终会失败的妊娠。
