Yolk Sac Size Can Predict Miscarriage
Objective: To identify the role of yolk sac size and its association with gestational sac size in predicting miscarriages.
Methods: Measurements of the gestational sac diameter, yolk sac diameter and crown-rump length were recorded. All of the patients were followed until term and those with loss of cardiac activity before 20th week of pregnancy were classified in the adverse pregnancy outcome group. We compared the measured characteristics of pregnancies with miscarriage and ongoing pregnancies reaching term.
Results: We followed 88 pregnancies. Four patients miscarried before the 20th week of pregnancy. A yolk sac diameter greater than the 95th percentile had a sensitivity of 33.3%, specificity of 80%, positive predictive value of 5.6% and negative predictive value of 78.4% for miscarriage. A yolk sac diameter greater than 4.6mm was associated with miscarriage before the 20th week of pregnancy.
Conclusions: An enlarged yolk sac may be predictive of a future miscarriage. Patients with an enlarged yolk sac should be offered a new ultrasound within 2 weeks. Sharing the results of an abnormal ultrasonography with the patient may create unnecessary anxiety. We only advise to use the favorable results as a reassuring sign to decrease the number of ultrasonographies.
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