Abstract
Objective The etiology of embryonic demise is multifactorial, with chromosomal abnormalities
being the most common (40%). The purpose of the present study is to evaluate the correlation
between a serum biomarker, progesterone, and an ultrasonographic parameter, the distance
between yolk sac and embryo (DYSE) in assessing the prognosis of pregnancy outcome
in the 1st trimester.
Methods The present study is a prospective case-control analysis that includes 2 groups of
patients: 81 patients with first-trimester normal evolutive pregnancy and 89 patients
with embryonic demise, all of the patients having between 6 and 11 weeks of amenorrhea.
Endovaginal ultrasonographic exploration was performed to evaluate the distance between
the lower pole of the embryo and the yolk sac. From each subject enrolled in the study,
20 ml of blood was collected for progesterone serum level measurement.
Results Regarding the DYSE in the case group, lower values were observed compared with the
control group, the difference being statistically significant. In the statistical
analysis of serum progesterone values, statistically significant differences were
observed between the 2 groups (p < 0.05).
Conclusion The DYSE has a high positive predictive value in identifying pregnancies with potentially
reserved outcome, with the present study demonstrating that a DYSE < 3 mm causes an
unfavorable evolution of the pregnancy. Low serum levels of progesterone are associated
with an increased rate of nonviable embryos. The correlation between these two parameters
increases the effectiveness of screening methods in prenatal monitoring and improves
the diagnostic methods for the first-trimester pregnancies whose outcome potential
can be reserved.
Keywords
first trimester - ultrasonography - progesterone - prognosis
