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Evaluation of Pregnancy Viability

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Managing Ultrasonography in Human Reproduction

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Abstract

Miscarriage is the most common complication of pregnancy. It is axiomatic that diagnosing pregnancy failure should be associated with 100 % specificity, with no risk of inadvertent termination of a healthy pregnancy. In 2011 a systematic review was published showing that the evidence base used to derive the criteria to diagnose miscarriage was inadequate. Two further papers in the same year showed the cutoff values used for mean sac diameter (MSD) and embryo crown-rump length (CRL) were associated with a significant false-positive rate. This resulted in national guidance changing to more conservative cutoff values that also account for the interobserver variability associated with ultrasound measurements. More recent evidence helps inform when nondiagnostic scans should be repeated and what structures should be seen on those repeat scans.

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Abbreviations

CRL:

Crown-rump length

LMP:

Last menstrual period

MSD:

Mean sac diameter

NICE:

National Institute for Health and Care Excellence

RCOG:

Royal College of Obstetricians and Gynaecologists

TVS:

Transvaginal scan

PUL:

Pregnancy of unknown location

PUV:

Pregnancy of uncertain viability

YS:

Yolk sac

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Acknowledgments

Tom Bourne is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health.

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Authors and Affiliations

  1. Queen Charlotte’s and Chelsea Hospital, Imperial College London, London, UK

    Jessica Farren & Tom Bourne

Authors
  1. Jessica Farren
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  2. Tom Bourne
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Correspondence to Tom Bourne .

Editor information

Editors and Affiliations

  1. Obstetrics and Gynecology Department, University of Cagliari, Cagliari, Italy

    Stefano Guerriero

  2. Department of Obstetrics and Gynecology Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

    Wellington P. Martins

  3. Obstetrics and Gynecology Department, Clinica Universidad de Navarra, Navarra, Spain

    Juan Luis Alcazar

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Farren, J., Bourne, T. (2017). Evaluation of Pregnancy Viability. In: Guerriero, S., Martins, W., Alcazar, J. (eds) Managing Ultrasonography in Human Reproduction. Springer, Cham. https://doi.org/10.1007/978-3-319-41037-1_12

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  • DOI: https://doi.org/10.1007/978-3-319-41037-1_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-41035-7

  • Online ISBN: 978-3-319-41037-1

  • eBook Packages: MedicineMedicine (R0)

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