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Waiting, Not Rushing, to Diagnose a Failed Pregnancy

Waiting, Not Rushing, to Diagnose a Failed Pregnancy Downloaded from http://journals.lww.com/ultrasound-quarterly by BhDMf5ePHKbH4TTImqenVA5KvPVPZ0P5BEgU+IUTEfzO/GUWifn2IfwcEVVH9SSn on 06/10/2020 COMMENTARY Waiting, Not Rushing, to Diagnose a Failed Pregnancy Deborah Levine, MD he American College of Radiology Appropriateness Criteria for imaging of first tri- Tmester bleeding published in Ultrasound Quarterly (June 2013) and the recent article in The New England Journal of Medicine (NEJM) (reprinted in this issue of Ultrasound Quarterly) address the important issues related to the diagnosis and misdiagnosis of mis- carriage based on the Society of Radiologists in Ultrasound conference, ‘‘Early first tri- mester diagnosis of miscarriage and exclusion of a viable intrauterine pregnancy,’’ which was held in Baltimore, MD, in October 2012. Of note in these publications are the very conservative guidelines for the diagnosis of failed pregnancy. These include thresholds for diagnosis of failed pregnancy at the time of an initial transvaginal ultrasound study of the following: (1) mean sac diameter (MSD) of 25 mm without an embryo or yolk sac and (2) crown rump length (CRL) of 7 mm without a heartbeat. The NEJM article also suggests that definitive diagnosis of miscar- riage requires a lack of visualization of an embryonic heartbeat 11 days after the visuali- zation of the yolk sac or 14 days after http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Ultrasound quarterly Wolters Kluwer Health

Waiting, Not Rushing, to Diagnose a Failed Pregnancy

Levine,, Deborah
Ultrasound quarterly , Volume 30 (1) – Mar 1, 2014
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Publisher
Wolters Kluwer Health
ISSN
0894-8771
eISSN
1536-0253
DOI
10.1097/RUQ.0000000000000069
Publisher site
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Abstract

Downloaded from http://journals.lww.com/ultrasound-quarterly by BhDMf5ePHKbH4TTImqenVA5KvPVPZ0P5BEgU+IUTEfzO/GUWifn2IfwcEVVH9SSn on 06/10/2020 COMMENTARY Waiting, Not Rushing, to Diagnose a Failed Pregnancy Deborah Levine, MD he American College of Radiology Appropriateness Criteria for imaging of first tri- Tmester bleeding published in Ultrasound Quarterly (June 2013) and the recent article in The New England Journal of Medicine (NEJM) (reprinted in this issue of Ultrasound Quarterly) address the important issues related to the diagnosis and misdiagnosis of mis- carriage based on the Society of Radiologists in Ultrasound conference, ‘‘Early first tri- mester diagnosis of miscarriage and exclusion of a viable intrauterine pregnancy,’’ which was held in Baltimore, MD, in October 2012. Of note in these publications are the very conservative guidelines for the diagnosis of failed pregnancy. These include thresholds for diagnosis of failed pregnancy at the time of an initial transvaginal ultrasound study of the following: (1) mean sac diameter (MSD) of 25 mm without an embryo or yolk sac and (2) crown rump length (CRL) of 7 mm without a heartbeat. The NEJM article also suggests that definitive diagnosis of miscar- riage requires a lack of visualization of an embryonic heartbeat 11 days after the visuali- zation of the yolk sac or 14 days after

Journal

Ultrasound quarterly – Wolters Kluwer Health

Published: Mar 1, 2014

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