Hyer JS, Fong S, Kutteh WH. Predictive value of the presence of an embryonic heartbeat for live birth: Comparison of women with and without recurrent pregnancy loss.
Fertil Steril 2004;
82:1369-73. [PMID:
15533362 DOI:
10.1016/j.fertnstert.2004.03.058]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2003] [Revised: 03/29/2004] [Accepted: 03/29/2004] [Indexed: 10/26/2022]
Abstract
OBJECTIVE
To determine the predictive value of an embryonic heart rate (EHR) for a live birth in women with and without a history of recurrent pregnancy loss (RPL).
DESIGN
Prospective cohort study with concurrent controls.
SETTING
A subspecialty clinic for couples with RPL.
PATIENT(S)
Three hundred pregnant women who previously had been diagnosed with RPL, followed prospectively compared with 300 age-, race-, and gestational age-matched pregnant control women.
INTERVENTION(S)
Transvaginal sonography between 6 to 8 weeks of gestation.
MAIN OUTCOME MEASURE(S)
The EHR was determined between 6 and 8 weeks of gestation by transvaginal sonography. Obstetrical history and current pregnancy outcome were evaluated.
RESULT(S)
Data were analyzed by using the two-tailed t test and Fisher's exact test. In women with RPL, an EHR predicted a successful live birth in 246 (82%) of 300, compared with 294 (98%) of 300 in control women. The mean (+/- SD) EHR from successful pregnancies in the control group (143.2 +/- 20.8 beats per minute) was significantly higher than the mean in women with a history of RPL (131.4 +/- 22.9 beats per minute).
CONCLUSION(S)
An EHR in women with RPL is associated with a live birth rate of 82% and is significantly lower than EHR in controls. Clinicians should use this information to counsel patients with RPL.
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