Predictors of early pregnancy loss: Findings from a case-control study
DOI:
https://doi.org/10.37800/RM.3.2026.772Keywords:
early pregnancy loss , ultrasound, Doppler, β-hCG, progesterone, predictive model, logistic regressionAbstract
Relevance: Early pregnancy loss (EPL) occurs in 10-20% of clinically recognized pregnancies. Identification of pregnancies at increased risk during the first trimester is clinically important. However, no single clinical, ultrasound, Doppler, or biochemical marker provides sufficient information across all cases. Therefore, this study examined these parameters together rather than considering individual markers separately.
The study aimed to identify clinical, ultrasound, Doppler, and laboratory characteristics associated with EPL and assess their combined predictive value.
Materials and Methods: This case-control study included 56 women with singleton pregnancies between 5 and 12 weeks of gestation. Twenty-seven women whose pregnancies continued formed the control group, and 29 women diagnosed with EPL comprised the case group. The assessment included clinical symptoms and first-trimester ultrasound findings, together with Doppler measurements and serum β-human chorionic gonadotropin (β-hCG), progesterone, and cancer antigen 125 (CA-125). We examined associations with EPL using multivariable logistic regression. We applied receiver operating characteristic (ROC) analysis to assess the model’s discriminatory performance
Results: Vaginal bleeding (75.9% vs. 14.8%), lower abdominal pain (69.0% vs. 18.5%), and threatened miscarriage (82.8% vs. 22.2%) were significantly more frequent in the EPL group (p < 0.001). Ultrasound assessment demonstrated reduced crown-rump length (6.8 mm vs. 9.7 mm) and higher fetal heart rate values in EPL cases (151.7 ± 15.7 bpm vs. 121.7 ± 6.3 bpm, p < 0.001). Absence of cardiac activity, abnormal yolk sac morphology, and subchorionic hematoma were also significantly associated with EPL. The predictive model showed high diagnostic performance, with an AUC of 0.997, sensitivity of 96.6%, and specificity of 96.3%.
Conclusion: EPL is associated with combined clinical, ultrasound, Doppler, and laboratory abnormalities. The developed multimodal model showed high predictive accuracy and may be useful for early risk stratification in clinical practice.
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