Frates M C, Benson C B, Doubilet P M
Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts 02115.
J Ultrasound Med. 1993 Jul;12(7):383-6. doi: 10.7863/jum.1993.12.7.383.
We conducted a prospective study to assess pregnancy outcome after a first trimester sonogram demonstrating a singleton intrauterine gestation with fetal cardiac activity. In each of the 556 cases, data recorded included indication for the sonogram, results of the sonogram, and pregnancy outcome. Sonographic abnormalities were found more frequently in patients scanned because of symptoms (14.0%) than among patients scanned for routine indications (6.0%) (P < 0.05, chi-squared). Among 556 patients with known outcomes, the overall loss rate was 9.4%. A trend was seen toward a higher loss rate in patients with abnormal than normal sonograms (15.2% versus 8.8%). The loss rate after a normal scan was similar in symptomatic (10.6%) and asymptomatic patients (9.1%) and declined progressively with gestational age from 17.0% at 6 to 7.9 weeks to 4.3% at 12 to 13 weeks (P < 0.01, chi-squared). These results can be used to convey prognostic information to patients after a normal first trimester sonogram demonstrating fetal cardiac activity. The likelihood of a good pregnancy outcome can be stated as a function of gestational age, and a symptomatic patient can be reassured after a normal scan that her prognosis is similar to that of an asymptomatic patient with a normal sonogram.
我们进行了一项前瞻性研究，以评估孕早期超声检查显示单胎宫内妊娠且有胎心活动后的妊娠结局。在556例病例中，记录的数据包括超声检查的指征、超声检查结果及妊娠结局。因症状进行超声检查的患者中超声异常的发现率（14.0%）高于因常规指征进行超声检查的患者（6.0%）（P<0.05，卡方检验）。在556例已知结局的患者中，总体流产率为9.4%。超声检查异常的患者流产率有高于正常患者的趋势（15.2%对8.8%）。正常超声检查后的流产率在有症状患者（10.6%）和无症状患者（9.1%）中相似，且随孕周逐渐下降，从6至7.9周时的17.0%降至12至13周时的4.3%（P<0.01，卡方检验）。这些结果可用于向孕早期超声检查正常且有胎心活动的患者传达预后信息。良好妊娠结局的可能性可表述为孕周的函数，有症状的患者在超声检查正常后可得到安慰，其预后与超声检查正常的无症状患者相似。
