Article Defining new guidelines for Nonviable Pregnancies

casandkls · October 2013

FYI: https://www.medscape.com/viewarticle/812346

Unknown · October 2013

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casandkls · October 2013

Sorry Rosie, I completely understand. I'm in the medical field and this info helped me because I want to prepare for my first U/S next week to know what the definitions are this time around.
If you feel it's inappropriate, let me know!

I'm hoping these new guidelines will improve patient care and reduce the risk of inadvertent harm.
Here's the new the new, more stringent, diagnostic criteria of nonviability:

"Crown–rump length of ≥7 mm and no heartbeat
Mean sac diameter of ≥25 mm and no embryo
Absence of embryo with heartbeat ≥2 [weeks] after a scan that showed a gestational sac without a yolk sac
Absence of embryo with heartbeat ≥11 days after a scan that showed a gestational sac with a yolk sac."

The report also lists 8 findings that are "suspicious for, but not diagnostic of, pregnancy failure":

"Crown–rump length of <7 mm and no heartbeat
Mean sac diameter of 16–24 mm and no embryo
Absence of embryo with heartbeat 7–13 days after a scan that showed a gestational sac without a yolk sac
Absence of embryo with heartbeat 7–10 days after a scan that showed a gestational sac with a yolk sac
Absence of embryo ≥6 wk after last menstrual period
Empty amnion (amnion seen adjacent to yolk sac, with no visible embryo)
Enlarged yolk sac (>7 mm)
Small gestational sac in relation to the size of the embryo (<5 mm difference between mean sac diameter and crown–rump length."

Junebug060609 · October 2013

Maybe I just have been around the AL boards too long (3 years now), but none of the bullets listed above is news to me. I like that they give actual measurements though.

It's really common for docs to give it a week or two if the sac/baby is measuring small...and likewise if a baby is large enough that it *should* have a hb and doesn't...well, that doesn't end well as so many of us know.

buggirl72 · October 2013

*lurking*

While I think it is good knowledge to have, I can see where Rosie was coming from on how this might be hard for some. My last loss falls into the category where another u/s should have been done, or, at least, the last u/s should have been a week later than it was.

Even though I have really good evidence that it was non-viable, I can't help but wonder if I had not stopped progesterone the day of the last scan, would I be graduating this week with all the other Oct PgALers.

BootsOrHearts · October 2013

I'm glad there is something published and it doesn't rely on days from LMP. I've heard of too many doctors saying a pregnancy is non-viable based on how far along things should have progressed from LMP. As we all know, LMP is a terrible way to date a pregnancy, it assumes we all have 28 day cycles and ovulate on day 14 which is simply not true. Even when we chart and tell them our O date, they want to still use LMP. Drives me batty.