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The Distance between the Embryo and the Yolk Sac in Correlation to the Serum Level of Placental Growth Factor: How Reliable is it?

Carmen Elena Bucuri, Razvan Ciortea,Valentin Aron Constantin Oprea, Andrei Mihai Malutan, Renata Nicula, Mihaela Daniela Oancea, Maria Patricia Rada, Dan Mihu

Background: The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (60%). The purpose of this study is to evaluate the correlation between a serum biomarker, Placental Growth Factor (PlGF) and an ultrasonographic parameter, the distance between Yolk Sac (YS) and embryo (DYSE), in assessing the prognosis of first trimester pregnancies outcome.

Materials and findings: The study is a case-control prospective analysis that includes two groups of patients: 81 patients with viable first-trimester pregnancy and 89 patients with embryonic demise, all of the patients having amenorrhea between 6 and 11 weeks. The endovaginal ultrasonographic exploration was performed to evaluate the distance between the lower pole of the embryo and the yolk sac. From each subject enrolled in the study, 20 ml of blood was collected for PlGF dosing.

Results: Regarding the DYSE in the case group, lower values were observed compared to the control group, the difference being statistically significant. In the statistical analysis of serum PlGF values, statistically significant differences were observed between the two groups (p<0.0001).

Conclusions: DYSE has a high positive predictive value in identifying pregnancies with potentially reserved outcome, this study demonstrating that a DYSE<3 mm may lead to an unfavorable pregnancy outcome. The low serum level of PlGF is associated with an increased rate of non-viable embryos.