ROLE OF FIRST-TRIMESTER ULTRASOUND (UP TO 12 WEEKS) IN EARLY PREGNANCY CARE: A RETROSPECTIVE OBSERVATIONAL STUDY

MUNAGALA SAHITHI; GAUTAM MUTHU

doi:10.22159/ajpcr.2025v18i11.57200

Authors

MUNAGALA SAHITHI Department of Radio Diagnosis, Rajarajeshwari Medical College and Hospital, Bengaluru, Karnataka, India.
GAUTAM MUTHU Department of Radio Diagnosis, Rajarajeshwari Medical College and Hospital, Bengaluru, Karnataka, India.

DOI:

https://doi.org/10.22159/ajpcr.2025v18i11.57200

Keywords:

First-trimester ultrasound, Early pregnancy, Ectopic pregnancy, Gestational age, Prenatal diagnosis

Abstract

Objectives: To evaluate the diagnostic and descriptive role of first-trimester ultrasound (FTU) in early pregnancy at a tertiary healthcare center.

Methods: A retrospective observational study was conducted in which 120 pregnant women who underwent FTU (≤12 weeks gestation) between March 2024 and February 2025. Archived imaging and hospital records were reviewed to analyze obstetric and ultrasound data. Outcomes assessed included gestational age confirmation, detection of fetal cardiac activity, yolk sac evaluation, and diagnosis of early pregnancy complications. Statistical analysis was performed using the Statistical Package for the Social Sciences v23.0.

Results: Of the 120 cases, 77.5% were viable singleton intrauterine pregnancies. Multifetal gestation was identified in 5.8% with chorionicity assessment possible in all twin pregnancies. Ectopic pregnancies and anembryonic gestations were each diagnosed in 5% of cases. Embryonic cardiac activity was present in 83.3% and yolk sac abnormalities were noted in 11.6%. The nuchal translucency was measured in 16.6% of cases (Mean NT 1.34±0.29 mm). Additional findings included subchorionic hematomas (3.3%) and adnexal masses (4.2%). Crown-rump length-based gestational dating closely agreed with last menstrual period-based estimates.

Conclusion: FTU plays an important role in early pregnancy care by ensuring early diagnosis of both normal as well as abnormal pregnancies. It improves obstetric decision-making through accurate dating, identification of viability, and early detection of complications.

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References

1. Papageorghiou AT, Kennedy SH, Salomon LJ, Altman DG, Ohuma EO, Stones W, et al. The INTERGROWTH-21st fetal growth standards: Toward the global integration of pregnancy and pediatric care. Am J Obstet Gynecol. 2018 Feb;218(2S):S630-40. doi: 10.1016/j. ajog.2018.01.011, PMID 29422205

2. Detti L, Francillon L, Christiansen ME, Peregrin-Alvarez I, Goedecke PJ, Bursac Z, et al. Early pregnancy ultrasound measurements and prediction of first trimester pregnancy loss: A logistic model. Sci Rep. 2020 Jan 31;10(1):1545. doi: 10.1038/s41598-020-58114-3, PMID 32005925. Erratum in: Sci Rep. 2021 Oct 28;11(1):21598. doi: 10.1038/s41598-021-01235-0, PMID 34711901

3. Bromley B, Platt LD. First-trimester ultrasound screening in routine obstetric practice. Obstet Gynecol. 2024;143(6):730-44. doi: 10.1097/ aog.0000000000005594, PMID 38723258

4. Van Den Hof MC, Smithies M, Nevo O, Oullet A. No. 375-clinical practice guideline on the use of first trimester ultrasound. J Obstet Gynaecol Can. 2019;41(3):388-95. doi: 10.1016/j.jogc.2018.09.020, PMID 30784569

5. Albuquerque Brás S, Ferreira L. First trimester scan in twins. Best Pract Res Clin Obstet Gynaecol. 2025 Oct 25;103:102684. doi: 10.1016/j. bpobgyn.2025.102684, PMID 41175677

6. Han MP, Ferreira AE, Elhindi J, McLennan AC, Scott F. How useful is nuchal translucency in detecting chromosomal abnormalities missed by genome-wide NIPT and what measurement threshold should be used? Prenat Diagn. 2025 Feb;45(2):147-54. doi: 10.1002/pd.6742, PMID 39754320, PMCID PMC11790515

7. Sundermann AC, Jasper EA, Kumar SE, Hartmann KE, Velez Edwards DR. Dating discrepancies on research ultrasonography and risk of pregnancy loss in a prospective cohort. Obstet Gynecol. 2025 Oct 01;146(4):515-23. doi: 10.1097/aog.0000000000006031, PMID 40811814, PMCID PMC12356491

8. Venkatachalam I, Siddique M. Antenatal ultrasound cannot detect all congenital Anomalies: Clinical limitations, India-specific barriers, and medicolegal perspectives. J Hand Microsurg. 2025 Jul 19;17(5):100331. doi: 10.1016/j.jham.2025.100331, PMID 40746435, PMCID PMC12309259

9. Murugan VA, Murphy BO, Dupuis C, Goldstein A, Kim YH. Role of ultrasound in the evaluation of first-trimester pregnancies in the acute setting. Ultrasonography. 2020 Apr;39(2):178-89. doi: 10.14366/ usg.19043, PMID 32036643, PMCID PMC7065984

10. Esteves KM, Tugarinov N, Lechmann G, Abi Habib P, Cagliyan E, Goetzinger KR, et al. The value of detailed first-trimester ultrasound in the era of noninvasive prenatal testing. Am J Obstet Gynecol. 2023 Sep;229(3):326.e1-6. doi: 10.1016/j.ajog.2023.05.031, PMID 37271433

11. Majola L, Budhram S, Govender V, Naidoo M, Godlwana Z, Lombard C, et al. Reliability of last menstrual period recall, an early ultrasound and a Smartphone App in predicting date of delivery and classification of preterm and post-term births. BMC Pregnancy Childbirth. 2021 Jul;21(1):493.x

12. Salomon LJ, Alfirevic Z, Berghella V, Bilardo C, Hernandez-Andrade E, Johnsen SL, et al. Practice guidelines for performance of the routine mid-trimester fetal ultrasound scan. Ultrasound Obstet Gynecol. 2011;37(1):116-26. doi: 10.1002/uog.8831, PMID 20842655

13. Kirk E, Bottomley C, Bourne T. Diagnosing ectopic pregnancy and current concepts in the management of pregnancy of unknown location. Hum Reprod Update. 2014;20(2):250-61. doi: 10.1093/humupd/ dmt047, PMID 24101604

14. Condous G, Okaro E, Khalid A, Timmerman D, Lu C, Bourne T, et al. The accuracy of transvaginal ultrasonography for the diagnosis of ectopic pregnancy prior to surgery. Hum Reprod. 2005;20(5):1404-9. doi: 10.1093/humrep/deh770

15. Dias T, Mahsud-Dornan S, Thilaganathan B, Papageorghiou AT. Early diagnosis of twin chorionicity by ultrasound: A systematic review. BJOG. 2011;118(5):523-9.

16. Denbow ML, Cox P, Taylor M, Hammal DM, Fisk NM. Placental angioarchitecture in monochorionic twin pregnancies: Relationship tofetal growth, fetofetal transfusion syndrome, and pregnancy outcome. Am J Obstet Gynecol. 2000;182(2):417-26. doi: 10.1016/s0002- 9378(00)70233-x, PMID 10694346

17. Lindsay DJ, Lovett IS, Lyons EA, Levi CS, Zheng XH, Holt SC, et al. Yolk sac diameter and shape at endovaginal US: Predictors of pregnancy outcome in the first trimester. Radiology. 1992;183(1):115-8. doi: 10.1148/radiology.183.1.1549656

18. Nicolaides KH, Spencer K, Avgidou K, Faiola S, Falcon O. Multicenter study of first-trimester screening for trisomy 21 in 75 821 pregnancies: Results and estimation of the potential impact of individual risk-orientated two-stage first-trimester screening. Ultrasound Obstet Gynecol. 2005;25(3):221-6. doi: 10.1002/ uog.1860, PMID 15736186

19. Johns J, Hyett J, Jauniaux E. Obstetric outcome after threatened miscarriage with and without a hematoma on ultrasound. Obstet Gynecol. 2003;102(3):483-7. doi: 10.1016/s0029-7844(03)00580-5, PMID 12962928

20. Condous G, Khalid A, Okaro E, Bourne T. Should we be examining the ovaries in pregnancy? Prevalence and natural history of adnexal pathology detected at first-trimester sonography. Ultrasound Obstet Gynecol. 2004 Jul;24(1):62-6. doi: 10.1002/uog.1083. PMID: 15229918.