Biochemical Versus ultrasound findings as predictors of fetal loss in cases of first trimester threatened miscarriage

Abstract

hreatened miscarriage is a clinically descriptive term applied to women who are less than 20 weeks of gestation having vaginal bleeding, closed cervical os and possibly mild uterine cramps. It may progress to a term viable pregnancy or miscarriage. Ultrasound is an accurate method for evaluating threatened miscarriage because it can establish the presence of a normal viable intrauterine pregnancy accurately and to distinguish this from either pregnancy failure or ectopic pregnancy. In cases of threatened miscarriage fetal bradycardia, discrepancy between gestational age and crown to rump length and abnormal yolk sac size are all adverse prognostic factors regarding fetal outcome. Progesterone is produced by the corpus luteum until about the 10th week of gestation. After about 8 weeks of gestation, the placenta replaces the ovary as the source of the progesterone. Before this time, surgical removal of corpus luteum will result in miscarriage unless exogenous progestin is given. According to Witt et al. (1990) Progesterone, due to its constancy in maternal serum during early normal gestation and due to its rapid metabolic clearance (<10 min), could potentially be an excellent marker for early pregnancy failure. CA-125 (cancer antigen-125) is a cell-surface antigen with high molecular weight. It increases in the first trimester as