Predicting pregnancy outcomes

My medscape subscription just offered up an article on predicting pregnancy outcomes, and I want to copy it and stick it up on the front page of every community board where someone is posting "no heartbeat at 7w does this pregnancy have a chance?" and getting lots of responses like - "Don't give up hope honey, I know someone who never saw a heartbeat and her son is now 4!!!"

The article says that three factors correlate to successful pregnancy outcomes. All factors can be measured by dildocam at between 33 and 36 days post-conception, or 6w5d - 7w1d. The three factors are fetal cardiac activity, yolk sac between 2 and 6mm and gestational sac diameter of 12mm or above. Importantly, "These markers were associated with favorable pregnancy outcome even in the poor prognostic subgroups of women of advanced maternal age and those with recurrent pregnancy loss." For women with recurrent miscarriage, 94% of pregnancies with these three markers resulted in take-home babies. For the over 40s, it was 82%. I know that's still a big grey area, but it's not a bad step in the right direction.

We all sort of knew this, but good to have it confirmed by 1092 pregnancies.

Comments

[niobe]

I appreciate hearing these kind of some numbers. Because when you spend a lot of time reading blogs of people who fall on the unlucky side of those percentages, you (or at least I) develop an incredibly skewed and pessimistic view of the world.

[perceval]

very interesting - thanks for sharing.

[Geohde]

I've been howled down on message boards for being the voice of rational scientific sense in response to dumb encouragement...

I mean there's positive thinking and there's magical thinking...

I don't bother anymore :)

g

[May]

Very interesting. Also, I get driven mad with all the wishful thinking. I remember reading one board, before I gave up on IF boards as being holding-pens for the terminally annoying, where some poor woman had had three scans, no sign of a heart-beat, and everyone was going 'oh, miracles happen!' and then the next day she posted in an absolute fury because she was bleeding and everyone had given her all this false hope for nothing and having it torn away was breaking her. So.

And to make it personal, I remember my mother asking me why I couldn't have cerclage when I was miscarrying. I explained about the no heart, let alone no heart-beat, thing, and her response was that perhaps it needed more time. Ah ha ha ha. This kind of stuff needs to be taught IN SCHOOL.

[OvaGirl]

Thanks Thalia, it is good to have that so clearly stated...

[Lut C.]

Thanks for posting this.

I've seen that kind of false-hope exchanges, but I'm reluctant to burst the bubble. By that time, it's usually to late anyway. The straw to cling to has been offered, so to speak.

[noela]

Thanks for this, Thalia.

I wish I had had this kind of information at hand when I was pregnant with the twins. It makes me wish I had all that data from my pregnancy, even now to compare.

And, to May above who posted about her mother who wondered why she couldn't have a cerclage to prevent a miscarriage....Yeah, I have a similar experience with my aunt.

After we had confirmation from two separate ultrasounds that the fetuses' had no heartbeats, and I was awaiting to miscarry, I spoke to one of my aunts on the phone. I told her that the pregnancy was over, and she said she would pray for it not be. I tried again to explain to her, no, it was really over, both babies had died and I was awaiting to miscarry or have D&C. And she actually said to me: "Well, then I will pray for them to be undead."

.....And then my brain fell out of my head, and crawled behind the sofa.

To this day, I'm not even really sure what I said in reply to her.

I'm sure her heart was in the right place, and she was probably just REALLY at a loss for words. But wow, that moment still tops my list of truly "WTF moments".

[Jenn]

That's interesting. I wonder what the numbers are on the flip side, if no fetal cardiac activity is seen in that time period. (if it's there, forgive me, my eyes are open by sheer willpower at the moment)

I have a knack for being on the wrong side of statistics. For my second pregnancy, we met all those criteria (I believe, I can't 100% sure on the other measurements, but I believe everything was right on target) and lost the baby. For my third (the boys), we did not see a heartbeat for Nick at 6w5d, though we did for William. He also measured a week behind for dates and a week behind his brother. They told me he'd most likely die. But he's upstairs pretending he's not tired when he so very clearly is.

[docgrumbles]

I got one of those "Don't worry, honey..." comments from an ER nurse. That hurt far more than the cramping that had already begun at that point.

This article (need to get the full article) makes me want to go back and look at my sac measurements from my second lost pregnancy.

I like getting my hands on sound scientific evidence instead of the pile of garbage "facts" tossed around the internet.

[Betty M]

I wish they would just wait until 7w to scan and then there would be a lot less people in limbo. But having come in teh wrong end of these stats I'm still a bit of a doom merchant.

[SPRA]

Thanks for posting this. I had a D&C at 8 weeks last year after they detected no fetal activity and suspected a blighted ovum. I've always wondered though since I had no external signs of a m/c and not been able to get pregnant ever since...
Wishing you all the best!