Human Reproduction, Vol. 10, No. 10, pp. 2696-2699, 1995
© 1995 European Society of Human Reproduction and Embryology
research-article |
Fetal loss in the first trimester after demonstration of cardiac activity: relation of cytogenetic and ultrasound findings
1Department of Obstetrics and Gynaecology 2Department Genetics, Hyogo College of Medicine 1-1 Mukogawa-Nishinomiya City 663, Japan
Correspondence: 3To whom correspondence should be addressed
A retrospective comparison of cytogenetic and ultrasound findings in first trimester spontaneous fetal loss after demonstration of cardiac activity was made. The crownrump length (CRL) was measured twice for each fetus resulting in spontaneous abortion: (i) CRL was measured in the viable state while demonstrating cardiac activity, and the growth deviation was expressed as the measured/ expected CRL ratio (M/E CRL ratio); (ii) in the same fetus, CRL was measured after confirmation of fetal death, and designated as the post-mortem CRL. The chorionic tissues of these abortuses were karyotyped. The CRL of fetuses which resulted in normal deliveries were also measured as controls. As a result, 16 of 24 abortuses displayed an abnormal chromosomal analysis (67%). Themean M/E CRL ratio of still-viable fetuses was smaller than that of control fetuses (0.74 ± 0.20 versus 0.98 ± 0.13 respectively, P < 0.01). The differences in ratio between karyotypically normal and abnormal abortuses were not statistically significant. The post-mortem CRL of dead fetuses was >20 mm in four of five monosomy X, two of three 21-trisomy, one of three triploidy and none of eight embryos with normal karyotype and five other trisomies. In conclusion, our study demonstrated that the M/E CRL ratio could be used as a predictor of spontaneous abortions, although it does not discriminate abnormal karyotypes from normal ones. The embryos with a post-mortem CRL more than 20 mm have a higher likelihood of suffering monosomy X or 21-trisomy. The ultrasonographic findings might offer a cytogenetic clue as to a possible cause to the developmental arrest.
Key words: chromosomal aberrations/crown-rump length (CRL)/spontaneous abortion/ultrasound
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