Outcome of First-Trimester Threatened Abortion with Slow Embryonic/Fetal Heart Rate Fewer Than 120 Beats/minute at Maharat Nakhon Ratchasima Hospital

Abstract

Background: Problems of management in first-trimester threatened abortion with slow embryonic/fetal heart rate are planning and prognosis. Objective: To determine outcome of first-trimester threatened abortion with slow embryonic/fetal heart rate fewer than 120 beats/minute. Patients &Methods: From October 1, 2006 to September 30, 2007, 39 pregnant women, diagnosed as first-trimester threatened abortion with embryonic/fetal heart rate fewer than 120 beats/minute, attending the out-patient clinic, Department of Obstetrics and  Gynecology, Maharat Nakhon Ratchasima Hospital, were recruited for this study. The ultrasonographic findings were recorded in regard to gestational age gestational sac size and appearance, fetal pole, fetal movement, fetal cardiac rate and activity, yolk sac and other abnormalities in uterine and pelvic cavity. All patients were followed until end of 20 weeks of pregnancy. Results: The mean age of pregnant women with first-trimester threatened abortion with embryonic/fetal heart rate fewer than 120 beats/minute was 25.6 years. Most of them had multigravidarum and no history of abortion. Mean gestational age was 8 weeks 6 days and mean day of vaginal bleeding was 2.2 days. Outcome of first-trimester threatened abortion in slow embryonic/fetal heart rate fewer than 120 beats/minute (n = 39) were embryonic/fetal death 24 cases, spontaneous abortion 10 cases (87.2%), and  normal pregnancy 5 cases (12.8%). In group of slow embryonic/fetal heart rate during 90-119 beats/minute (n = 19) were embryonic/fetal death 10 cases, spontaneous abortion 4 cases (73.7%), and  normal pregnancy 5 cases (26.3%) and in groups of slow embryonic/fetal heart rate fewer than 90 beats/minute (n = 20) were embryonic/fetal death 14 cases, and spontaneous abortion 6 cases (100%). Conclusion: Outcome of first-trimester threatened abortions with slow embryonic/fetal heart rate fewer than 120 beats/minute (n = 39), during 90-119 beats/minute (n = 19), and fewer than 90 beats/minute (n = 20) were abortions 87.2%, 73.7%, and 100%, respectively.