Sm. Qasim et al., THE PREDICTIVE VALUE OF FIRST-TRIMESTER EMBRYONIC HEART-RATES IN INFERTILITY PATIENTS, Obstetrics and gynecology, 89(6), 1997, pp. 934-936
Objective: To analyze whether first-trimester embryonic (fetal) heart
rates (FHR) are useful in predicting pregnancy outcome for infertility
patients. Methods: Patients in a university-based reproductive endocr
inology and infertility practice were studied prospectively. Infertile
women who achieved clinical pregnancy underwent first-trimester trans
vaginal sonographic evaluation, and FHR in patients achieving viable p
regnancies were compared with those experiencing fetal loss. Results:
Overall, 99 pregnancies reached viability and 17 resulted in fetal los
s before 20 weeks' gestation. Patient age, methods of conception, and
number of previous fetal losses did not differ significantly between t
he two groups. A significant correlation (r = .70, P < .001) was found
between increasing FHR levels and advancing gestational age in patien
ts with viable pregnancies and, although to a weaker extent, patients
who miscarried (r = .52, P < .05). A significantly higher number of vi
able pregnancies, compared with fetal losses, had FHR falling within o
ne (70.7% compared with 41.2%, P < .025) and two (99.0% compared with
64.7%, P < .001) standard deviations of the mean for viable pregnancie
s at corresponding gestational ages. The majority of FHR of failing pr
egnancies fell below the individual reference ranges. Conclusion: Firs
t-trimester FHR can help predict pregnancy outcome for infertility pat
ients. Women with FHR outside the reference range from the mean for vi
able pregnancies at corresponding gestational ages may be at risk for
eventual pregnancy loss. (C) 1997 by The American College of Obstetric
ians and Gynecologists.