Comparison of ultrasonographic findings in spontaneous abortions with normal and abnormal karyotypes |
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Authors: | Coulam CB; Goodman C; Dorfmann A |
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Institution: | Genetics & IVF Institute, Fairfax, VA 22031, USA. |
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Abstract: | To determine whether ultrasonographic findings can predict the karyotype of
spontaneous abortions, 137 pregnancies (54 spontaneous, 83 assisted
ovulatory cycles) that subsequently aborted and had chromosome analysis
performed on the products of conception were studied ultrasonographically.
Transvaginal ultrasound was performed using an Acuson 128XP/10 with 7.5 MHz
probe. The numbers of empty gestational sacs, small and normal for
gestational size, embryonic poles and embryos with documented cardiac
activity were calculated. The frequency of each of these findings in
pregnancies with normal and abnormal karyotypes was compared. Of the 137
spontaneous abortions, 51 had normal chromosome analyses and 86 had
abnormal karyotypes (68 aneuploidies and 18 polyploidies). Ultrasonographic
findings in the 51 karyotypically normal pregnancies included 16 (31%) with
empty gestational sacs, and 35 (69%) with embryonic poles, of which 24
(69%) were at least 1 week smaller than expected for gestational age and 11
(31%) were the expected size. Embryonic cardiac activity was documented in
22 (63%) of the 35 embryonic poles. Amongst 86 pregnancies with abnormal
karyotypes, similar frequencies of ultrasound findings were found: 23 (27%)
with empty gestational sacs, 42 (67%) with embryonic poles smaller than
expected for gestational age, and 50 (79%) embryos lost after documentation
of embryonic cardiac activity. No differences in the frequency of
ultrasonographic findings of empty gestational sacs, small embryonic pole
and embryonic cardiac activity were observed between karyotypically normal
and abnormal spontaneous abortions. Ultrasonographic findings cannot
predict the karyotype of spontaneous abortions.
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