Volume 82, Issue 11 p. 849-857

THE DIAGNOSIS OF EARLY PREGNANCY FAILURE BY SONAR

Hugh P. Robinson

Hugh P. Robinson

Glasgow University Department of Midwifery Queen Mother's Hospital, Glasgow G3 8SH

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First published: November 1975
Citations: 95

Summary

In a series of 425 consecutive patients examined by sonar in the first half of pregnancy 176 ultimately aborted. On analysis of the sonar and post-abortion findings it was found that the aborted pregnancies fell into five clearly defined groups; blighted ova or anembryonic pregnancies, missed abortions, hydatidiform moles and early and late live abortions. The blighted ova and the missed abortions comprised by far the largest and the early live abortions the smallest groups. Strict diagnostic sonar criteria of abnormality, independent of menstrual or clinical histories, were established for the first three of the groups, and an absolute diagnosis could be made at the time of the first examination in all cases of missed abortion and hydatidiform mole and in just over half of the cases of blighted ovum, the remainder requiring a second and occasionally a third examination. In the first half of the study the majority of the patients were allowed to abort spontaneously but with increasing confidence in the techniques patients were offered termination whenever the diagnosis of an abortive pregnancy was made. Anticipation of fetal death in utero or impending abortion of a live fetus proved to be a much more difficult problem, and in only those patients who aborted a live fetus before the tenth week of pregnancy did the sonar examination reveal any significant abnormality. Possible aetiological backgrounds to these groups of abortions are discussed in the light of the sonar findings.

I am grateful to Professor Ian Donald for his advice and comments during this investigation and I thank the obstetric consultants of the Queen Mother's Hospital whose patients were included in this study, and Mr J. Devlin and his department for preparing the illustrations. This work was performed under the provisions of a Medical Research Council Programme Grant in the University of Glasgow, with Professor Ian Donald as the Programme Leader.