Table 6.2GRADE summary of findings for evaluation of ultrasound for determining a viable intrauterine pregnancy

Number of studiesType of ultrasound scan (transvaginal [TVU] or transabdominal [TAU])Number of women scanned for fetal cardiac activity, and stratified by fetal size/age (total study participants)Threshold at which 100% of fetuses that later proved to be viable can be identifiedQuality
Visualisation of cardiac activity by crown–rump length (mm)
1 study

(Rempen, 1990)
5 MHz TVU292

(363)
3High
1 study

(Pennell et al., 1991)
5 MHz / 3.5 MHz TAU

5 MHz / 7.5 MHz TVU
175

(175)
TAU: 9 TVU: 5High
1 study

(Hassan et al., 2009)
TVU1174

(1174)
6.0Moderate
1 study

(Abaid et al., 2007)
8 MHz TVU179

(179)
3.5Moderate
1 study

(Brown et al., 1990)
5 MHz TVU375

(375)
5Moderate
1 study

(Abdallah et al., 2011)
6–12 MHz TVU179

(1060)
5.3Low
1 study

(Levi et al., 1990)
6.5 MHz TVU71

(71)
4.0Low
1 study

(Goldstein, 1992)
5 MHz / 7.5 MHz TVU96

(96)
4Low
Visualisation of cardiac activity by gestation sac diameter (mm)
1 study

(Rempen, 1990)
5 MHz TVU354

(363)
18.3 *High
1 study

(Abdallah et al., 2011)
6–12 MHz TVU462§

(1060)
21Moderate
419§

(1060)
21
1 study

(Bree et al., 1989)
7 MHz TVU53

(53)
> 9Moderate
1 study

(Rowling et al., 1999)
9-5 MHz TVU39

(39)
13Low
1 study

(Levi et al., 1988)
6.5 MHz TVU35

(62)
16Very low
1 study

(de Crespigny, 1988)
5 MHz TVU353

(353)
> 12Low
1 study

(Steinkampf et al., 1997)
5 MHz TVU82

(82)
19Very low
1 study

(Cacciatore et al., 1990)
5 MHz / 6.5 MHz TVU20

(22)
> 18Very low
Visualisation of cardiac activity by gestational or menstrual age (days)
1 study

(Rempen, 1990)
5 MHz TVU252

(363)
46

(menstrual age)
High
1 study

(Bree et al., 1989)
7 MHz TVU53

(53)
> 40

(gestational age)
Moderate
1 study

(Steinkampf et al., 1997)
5 MHz TVU82

(82)
45.5

(gestational age)
Very low
1 study

(Ferrazzi et al., 1993)
5 MHz TAU / 5 MHz TVU76

(598)
TAU: 37

TVU: 35

(menstrual age)
Very low
1 study

(Cacciatore et al., 1990)
5 MHz / 6.5 MHz TVU20

(22)
> 43

(gestational age)
Very low

TAU transabdominal ultrasound, TVU transvaginal ultrasound

*

Chorionic cavity diameter

Point of 99% probability of visualisation

Point of ’reliable detection’

§

462 scans showed a gestation sac without a visible embryo or yolk sac. 419 scans showed a gestation sac with a yolk sac, but without a visible embryo.

From: 6, Diagnosis of ectopic pregnancy and miscarriage

Cover of Ectopic Pregnancy and Miscarriage
Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage.
NICE Clinical Guidelines, No. 154.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG; 2012 Dec.
Copyright © 2012, National Collaborating Centre for Women's and Children's Health.

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