Predictive value of the presence of an embryonic heartbeat for live birth: comparison of women with and without recurrent pregnancy loss.
OBJECTIVE
To determine the predictive value of an embryonic heart rate (EHR) for a live birth in women with and without a history of recurrent pregnancy loss (RPL).


METHODS
Prospective cohort study with concurrent controls.


METHODS
A subspecialty clinic for couples with RPL.


METHODS
Three hundred pregnant women who previously had been diagnosed with RPL, followed prospectively compared with 300 age-, race-, and gestational age-matched pregnant control women.


METHODS
Transvaginal sonography between 6 to 8 weeks of gestation.


METHODS
The EHR was determined between 6 and 8 weeks of gestation by transvaginal sonography. Obstetrical history and current pregnancy outcome were evaluated.


RESULTS
Data were analyzed by using the two-tailed t test and Fisher's exact test. In women with RPL, an EHR predicted a successful live birth in 246 (82%) of 300, compared with 294 (98%) of 300 in control women. The mean (+/- SD) EHR from successful pregnancies in the control group (143.2 +/- 20.8 beats per minute) was significantly higher than the mean in women with a history of RPL (131.4 +/- 22.9 beats per minute).


CONCLUSIONS
An EHR in women with RPL is associated with a live birth rate of 82% and is significantly lower than EHR in controls. Clinicians should use this information to counsel patients with RPL.
Hyer
Jennifer S
JS
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Immunology, University of Tennessee, Memphis, Tennessee 32120-2363, USA.
Fong
Shirley
S
Kutteh
William H
WH
D000026:Abortion, Habitual / Q000503:physiopathology*; D000328:Adult; D001723:Birth Rate; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies