Smaller than expected crown-rump length ultrasound measurements in 1st-trimester pregnancy: does it have any risk of subsequent pregnancies?

AUTHOR(s) : Konwar R
DOI No. : 10.31741/ijhrmlp.v8.i2.2022.8


Background and aims: Crown-rump length (CRL) measurement is usually used to predict threatened abortion or spontaneous miscarriage in early pregnancy. The present study aimed to examine whether there is any association between smaller-than-expected CRL and subsequent adverse pregnancy outcomes in the population under study. Materials and methods: This prospective study included 256 pregnant women with intrauterine, viable singleton spontaneous pregnancies with 6-13 weeks of gestation attending the Obstetrics and Gynaecology department, Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta. The expected CRL was determined based on a recognized growth curve of gestational age and CRL. The observed and expected CRL deviations were expressed as a z-score and evaluated between the miscarried and viable pregnancy groups. Results: The average maternal age at enrolment was 26.2±5.9 years. The majority (52.7%) of women were nulliparous. Most of the participants (62.9%) women had completed education up to the secondary level and had an average body mass index (60.5%). The mean gestational age was 9.4±1.5 weeks. Among 256 pregnant women, 26(10.1%) resulted in spontaneous miscarriages. The mean z score of CRL was significantly lower among the miscarried group than the continued pregnancy group (-1.91 vs -0.86, p-value 0.03). Also, the mean maternal age was considerably higher (30.50 vs 25.74, p-value< 0.01) in the miscarried group than in the continued pregnancy group. Conclusion: Smaller than expected crown rump length is a potential contributing factor for subsequent pregnancy loss. Ultrasound biometry evaluation may offer important information regarding fetal growth and threatened miscarriage.

Keywords: Crown-rump length; gestational age; maternal age; body-mass index.

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