PREGNANCY OUTCOME FOLLOWING ULTRASOUND-DETECTED FETAL CARDIAC ACTIVITY IN WOMEN WITH A HISTORY OF MULTIPLE SPONTANEOUS-ABORTIONS

OBJECTIVE: To determine whether women with two or more previous sponta neous abortions of unknown etiology, by conventional testing criteria, have a different rate of subsequent fetal loss than controls after ul trasonic documentation of fetal cardiac activity. METHODS: Medical rec ords were reviewed from 185 women with spontaneous abortion of unknown etiology. Of these women, 91.9% were found to have evidence of cellul ar immunity to trophoblast and were treated with progesterone for immu nosuppression. Ultrasound evaluation was obtained at 5-6 weeks' gestat ion to document fetal cardiac activity. A control group of 63 women wa s also studied. All women were followed for pregnancy outcome. RESULTS : A total of 248 pregnancies were identified from the 185 study patien ts with multiple spontaneous abortions. Fetal cardiac activity was vis ualized by ultrasound in 209 pregnancies from 171 study subjects; of t hese, the outcomes of 208 pregnancies were known. The rate of spontane ous abortion after ultrasound documentation of fetal cardiac activity was 22.7%. Neither maternal age nor number of previous losses was asso ciated with an increased incidence of spontaneous abortion following d ocumentation of fetal cardiac activity. The rate of spontaneous aborti on in the control group after documentation of fetal cardiac activity was 3.3%. CONCLUSION: These data may help clinicians give couples who have experienced recurrent pregnancy loss a more realistic prognosis f or pregnancy success once fetal cardiac activity has been confirmed.