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Clinical and Experimental Obstetrics & Gynecology  2021, Vol. 48 Issue (1): 168-174    DOI: 10.31083/j.ceog.2021.01.2215
Original Research Previous articles | Next articles
To operate or to wait? Doppler indices as predictors for medical termination for first trimester missed abortion
Wassan Nori1, Muna Abdulghani2, Ali B Roomi3, 4, *(), Wisam Akram5
1Department of Obstetrics and Gynecology, College of Medicine, Al-Mustansiriyah University, 10052 Iraq
2Department of Radiology, College of Medicine, Al-Mustansiriyah University, 10052 Iraq
3Ministry of Education, Directorate of Education Thi-Qar, Thi-Qar, 64001 Iraq
4College of Health and Medical Technology, Al-Ayen University, Thi-Qar, 64001 Iraq
5Consultant Obstetrician and Gynecologist, AL-Yarmook Teaching Hospital, 10015 Iraq
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Abstract  
Purpose: Missed abortion is a common obstetrical problem with a high incidence. Evidence supports a change in approach from the traditional dilatation and curettage to medical; however, few studies have investigated the prediction success of the medical approach. This study investigates whether first trimester missed abortion can be successfully terminated using Doppler indices, such as resistance index (RI) and pulsatility index (PI), as predictors. Material and Method: In this prospective study, the sample is made up of 78 patients, with a first trimester missed abortion range of 6-13 weeks of pregnancy and who meets the maternal parameters as well as transvaginal Doppler indices, RI and PI. The participants were subdivided into 3 groups based on their response to sublingual misoprostol and weeks needed to terminate as Groups I (43/78), II (26/78), and III (9/78) aborted in the first, second, and third weeks, respectively. Results: Age, BMI, and gestational age of dead fetus were not significant for Groups I, II, and III with P = 0.13, P = 0.13, and P = 0.35, respectively. Parity and delivery mode showed significant differences (P < 0.0001) between group means of PI and RI. PI for Group I plus II and Group III are 1.53 (0.75-2.70) and 1.58 (1.10-2.10), respectively. RI for Group I plus II and Group III are 0.71 (0.50-1.00) and 0.80 (0.69-0.92), respectively. The coefficient of correlation proves that RI is the primary predictor of successful termination of a first trimester missed abortion with a cut-off value of 0.74 and associated sensitivity and specificity of 68.7% and 56.7%, respectively. Conclusions: Increased parity and a history of vaginal delivery, in addition to measured RI, were predictors of successful termination of a first trimester missed abortion. These results may be used in counseling patients who are deciding on the safest and most suitable option to terminate a first trimester missed abortion, depending on their demographic criteria and ultrasound scores.
Key words:  Missed abortion      First trimester      Misoprostol      Doppler      Resistance index      Pulsatility index     
Submitted:  08 July 2020      Revised:  11 September 2020      Accepted:  17 September 2020      Published:  15 February 2021     
*Corresponding Author(s):  alibadr205@gmail.com; dr.ali_bader@alayen.edu.iq (Ali B Roomi)   

Cite this article: 

Wassan Nori, Muna Abdulghani, Ali B Roomi, Wisam Akram. To operate or to wait? Doppler indices as predictors for medical termination for first trimester missed abortion. Clinical and Experimental Obstetrics & Gynecology, 2021, 48(1): 168-174.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2021.01.2215     OR     https://ceog.imrpress.com/EN/Y2021/V48/I1/168

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