Ultrasonographic Estimation of Gestational Sac Diameter in Normal Pregnancy, Missed Abortion and Blighted Ovum in Early Pregnancy and Its Sequel Abdul-Zahra Alsharifi* FRCOG, Henan Dh Skheel Aljebory*, Susan Ibrahem Ali Muhsin** MBChB
Abstract
Background: Missed abortion and blighted ovum are associated with maternal morbidity and mortality, so early and accurate diagnosis means early management and less complications.
Objective: To compare gestational sac size between normal pregnancy and missed abortion and blighted ovum to determine at what gestational age differences in gestational sac size become evident. Also, to see whether it is possible that we can use it as a parameter to differentiate between normal and abnormal pregnancies, especially at early stages, when diagnosis of failed pregnancies can be difficult.
Methods: A prospective observational study at Department of Gynecology and Obstetrics at Al-Yarmouk Teaching Hospital for a period of one year from the first May 2015 to the first of May 2016 on 113 women with early pregnancy were included in this study. Two dimensional abdominal ultrasound of the gestational sac size was done and follow up weekly starting at 6 week until 9+6 weeks by serial ultrasound measurement of the sac size and its sequel, and comparison was made between the subgroups (normal early pregnancy, missed abortion, blighted ovum).
Results: There were 56 normal early pregnancies 46 missed abortions and 11 blighted ovum. Gestational sac size was significantly larger in normal pregnancies compared to missed abortion and blighted ovum, this difference started at 7 week between normal pregnancy and missed abortion: 23.3±2.2 cm2 and 20.5±3.2 cm2 , respectively (p < 0.001), and 8 week between normal pregnancy and blighted ovum: 30.9±2 cm2 and 26.4±3.5 cm2 , respectively (p < 0.001). And the differences keep increasing during the ninth and tenth weeks of gestation
Conclusion: Gestational sac size in missed abortion and anembryonic pregnancies is significantly smaller than in normal pregnancies, starting at 7 weeks for missed abortion and 8 weeks for blighted ovum.
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