FETAL LOSS AFTER EARLY DETECTION OF HEART MOTION IN INFERTILITY PATIENTS - PROGNOSTIC FACTORS

OBJECTIVE: To evaluate the incidence and prognosticators of spontaneou s abortion (< 20 weeks' gestation) in an infertile population after ea rly documentation of fetal cardiac activity. STUDY DESIGN: Retrospecti ve chart review. We examined the incidence of spontaneous abortion in 231 clinical pregnancies with 259 fetuses documented to be viable by t ransvaginal sonography 28-38 days after ovulation. The population teas an unselected group of infertility patients with no history of recurr ent pregnancy loss. Maternal age and presence of multiple gestations w ere analyzed as separate variables by chi(2) testing. RESULTS: The inc idence of spontaneous abortion among all fetuses was 9.6% (95% confide nce interval [CI], 6.1-13.2%) and among singleton gestations was 7.7% (95% CI, 4.0-11.3%). Women with multiple gestations were more likely t o stiffer spontaneous fetal loss as compared to women with singleton g estations (18 vs. 7.6%, P < .05). In addition, women aged 35 and above with singleton pregnancies showed a significantly increased rate of f etal loss (13.4 vs. 4.9%, P < .05) when compared with younger women. C ONCLUSION: Women 235 years old and those with multiple gestations were significantly move likely to suffer late first-or early second-trimes ter fetal loss even after detection of fetal cardiac activity. These p atients should be counseled differently than younger women with single ton pregnancies, and increased monitoring may be indicated.