Key result
Fetal bradycardia (<130 bpm) and short cervix (<40 mm) were significant predictors of fetal loss before 20 weeks' gestation, with FHR <130 bpm showing 81.4% sensitivity and 85.1% specificity.
Cohort (n=202)
p-value: p=<0.001
In a low socioeconomic population with threatened abortion and documented fetal cardiac activity, fetal loss occurs in approximately 27% of cases, with fetal bradycardia and short cervical length serving as significant predictors.
May inform monitoring in threatened abortion; hypothesis-generating and requires prospective validation before practice change.
This study was conducted to determine the incidence and risk factors of fetal loss in threatened abortion after ultrasonographic detection of fetal cardiac activity in a low socioeconomic population. A total of 202 women with singleton pregnancies who presented with vaginal bleeding in which fetal heart activity was ultrasonographically demonstrated between 5 and 14 weeks' gestation were included. Pregnancies with fetal abnormalities were excluded from the study. All cases were followed-up with respect to pregnancy outcomes. A total of 54 of 202 pregnancies (26.7%) resulted in fetal loss before 20 weeks' gestation. The mean fetal heart rate (FHR) and cervical length values were lower in spontaneous abortions than in viable pregnancies (121.2 +/- 13.3 vs 143.5 +/- 12.4 and 41 +/- 6.0 vs. 34.8 +/- 6.1, respectively; p < 0.001). A receiver operating characteristic (ROC) curve analysis revealed an area under the curve of 0.88 for FHR and 0.77 for cervical length. A FHR value <130 b.p.m. was 81.4% sensitive, 85.1% specific and a cervical length value <40 mm was 80.8% sensitive, 54.7% specific for determination of fetal loss before 20 weeks' gestation. Fetal loss was observed in about one-quarter of pregnancies admitted with threatened abortion in a low socioeconomic population. Bradycardia and short cervix were found to be significant risk factors affecting the pregnancy outcome in women presenting with vaginal bleeding, in whom fetal cardiac activity was documented.
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Dede et al. (2010) conducted a cohort in Threatened abortion (n=202). Fetal heart rate and cervical length vs. Normal fetal heart rate and cervical length was evaluated on Fetal loss before 20 weeks' gestation (p=<0.001). Fetal bradycardia (<130 bpm) and short cervix (<40 mm) were significant predictors of fetal loss before 20 weeks' gestation, with FHR <130 bpm showing 81.4% sensitivity and 85.1% specificity.
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