Discriminant analysis forecasting model of first trimester pregnancy outcomes developed by following 9963 infertile patients after in vitro fertilization

Capsule:
A forecasting method was developed to predict first trimester pregnancy outcomes through ultrasound scan on days 27–29 after ET and the follow-up can be planned accordingly.

Authors:
Yan Yi, M.D., Xihong Li, Ph.D., M.D., Yan Ouyang, M.D., Ge Lin, Ph.D., M.D., Guangxiu Lu, Ph.D., M.D., Fei Gong, Ph.D, M.D.

Volume 105, Issue 5, Pages 1261-1265

Abstract:

Objective:
To investigate a forecasting method developed to predict first trimester pregnancy outcomes using the first routine ultrasound scan for early pregnancy on days 27–29 after ET and to determine whether to perform a repeated scan several days later based on this forecasting method.

Design:
Prospective analysis.

Setting:
Infertile patients at an assisted reproductive technology center.

Patient(s):
A total of 9,963 patients with an early singleton pregnancy after in vitro fertilization (IVF)-ET.

Intervention(s):
None.

Main Outcome Measure(s):
Ongoing pregnancy >12 weeks of gestation.

Result(s):
The classification score of ongoing pregnancy was equal to (1.57 × Maternal age) + (1.01 × Mean sac diameter) + (−0.19 × Crown-rump length) + 25.15 (if cardiac activity is present) + 1.30 (if intrauterine hematomas are present) − 47.35. The classification score of early pregnancy loss was equal to (1.66 × Maternal age) + (0.84 × Mean sac diameter) + (−0.38 × Crown-rump length) + 8.69 (if cardiac activity is present) + 1.60 (if intrauterine hematomas are present) − 34.77. In verification samples, 94.44% of cases were correctly classified using these forecasting models.

Conclusion(s):
The discriminant forecasting models are accurate in predicting first trimester pregnancy outcomes based on the first scan for early pregnancy after ET. When the predictive result is ongoing pregnancy, a second scan can be postponed until 11–14 weeks if no symptoms of abdominal pain or vaginal bleeding are present. When the predictive results suggest early pregnancy loss, repeated scans are imperative to avoid a misdiagnosis before evacuating the uterus.

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