Assessing the predictive value of first trimester ultrasound and biochemical markers in miscarriage

Abstract

Vaginal bleeding in the first trimester causes significant anxiety for expectant parents. Although ultrasound plays a central role in early pregnancy assessment, predicting miscarriage remains challenging. This scoping review examined the predictive value of first-trimester ultrasound (US) markers used alone, in combination, or alongside biochemical (BC) markers. A systematic search of four databases (20 January 2022 and 23 March 2023) using MeSH terms identified 3,608 studies. After screening, 128 studies were included (82 single-US-marker studies and 46 multiple-marker studies). The most frequently investigated US markers were intrauterine haematoma, yolk sac, and fetal heart rate; progesterone was the commonest BC marker. While several markers showed promising predictive value, methodological variations across studies mean no standardised predictive model currently exists for clinical use.