{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T23:39:05Z","timestamp":1757547545038,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,5,17]],"date-time":"2024-05-17T00:00:00Z","timestamp":1715904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess first\u2010trimester prognosis when an early pregnancy sonogram demonstrates a normal embryonic heart rate and to determine how a number of risk factors affect prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our study population consisted of 6597 first\u2010trimester scans with gestational age (GA)\u2009\u2264\u20097.0\u2009weeks (all with crown\u2010rump length [CRL] &lt;10\u2009mm), normal embryonic heart, and known first\u2010trimester outcome. We recorded GA; CRL; heart rate; first\u2010trimester outcome; maternal age; presence, absence, and size of subchorionic hematoma; presence or absence of vaginal bleeding; and presence, absence, and size of uterine fibroids. We assessed first\u2010trimester outcome in the study population and subsets based on the above data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>First\u2010trimester outcome was successful in 6030 of the 6597 cases (91.4%). The prognosis was somewhat worse with each of the following risk factors: maternal age \u226535\u2009years, large subchorionic hematoma, and large or multiple uterine fibroids (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.02, chi\u2010squared or Cochran's test for trend, for all of these items). The rate of successful outcome was in the range of 83\u201388% with each of these risk factors and 93.8% in the absence of any of these factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The presence of a normal embryonic heart rate on an early first\u2010trimester sonogram is a reassuring finding, indicating a likelihood of good first\u2010trimester outcome of at least 83% even in the presence of risk factors, and of over 90% in the absence of such factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jum.16485","type":"journal-article","created":{"date-parts":[[2024,5,18]],"date-time":"2024-05-18T06:54:21Z","timestamp":1716015261000},"page":"1637-1643","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors Are Not Very Risky Once a Normal Embryonic Heart Rate is Seen in Early Pregnancy"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4264-2752","authenticated-orcid":false,"given":"Peter M.","family":"Doubilet","sequence":"first","affiliation":[{"name":"Department of Radiology Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5589-4003","authenticated-orcid":false,"given":"Yang","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Radiology Brigham and Women's Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,5,17]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"118","volume-title":"Callen's Ultrasonography in Obstetrics and Gynecology","author":"Doubilet PM","year":"2017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.153.1.75"},{"key":"e_1_2_7_4_1","first-page":"885","article-title":"Evaluation of normal gestational sac growth: appearance of embryonic heartbeat and embryo body movements using the transvaginal technique","volume":"77","author":"Goldstein I","year":"1991","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)59884-7"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.182.2.1732970"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002682"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198807283190401"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)58144-8"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/HUMREP\/11.2.406"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(02)04694-0"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws393"},{"key":"e_1_2_7_13_1","first-page":"1869","article-title":"Role of maternal age and pregnancy history in risk of miscarriage: prospective register based study","volume":"364","author":"Magnus MC","year":"2019","journal-title":"BMJ"},{"volume-title":"Miscarriage. 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