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Joe Leigh Simpson, MD; James L. Mills, MD; Lewis B. Holmes, MD; Carole L. Ober, PhD; Jerome Aarons, MD; Lois Jovanovic, MD; Robert H. Knopp, MD

JAMA. 1987;258(18):2555-2557.

Abstract
Once pregnancy is recognized clinically, it is accepted that 12% to 15% undergo spontaneous abortion. However, the actual time of fetal demise has not yet been determined. To address this question, the outcomes of pregnancies identified before 21 days of conception by serum β-human chorionic gonadotropin assays were studied. All subjects underwent ultrasound examinations at eight and 12 weeks' gestation. Among 220 women who had a viable pregnancy at eight weeks, only seven (3.2%) experienced a fetal loss thereafter. The results of this study suggest that most clinically recognized spontaneous abortions manifested after eight weeks actually represent pregnancies in which fetal demise occurred before eight weeks. These findings have important implications with respect to the safety of chorionic villi sampling and to the identification of exogenous agents that cause fetal wastage.

(JAMA 1987;258:2555-2557)

Author Affiliations
The Diabetes in Early Pregnancy Study

From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (Drs Simpson and Ober); the National Institute of Child Health and Human Development, Bethesda, Md (Dr Mills); the Departments of Pediatrics and Obstetrics/Gynecology, Harvard University, Boston (Dr Holmes); the Departments of Medicine and Obstetrics/Gynecology, University of Pittsburgh (Dr Aarons); the Department of Medicine, Cornell Medical College, New York (Dr Jovanovic); and the Department of Medicine, University of Washington, Seattle (Dr Knopp). Dr Simpson is now with the University of Tennessee, Memphis, and Dr Jovanovic is now with the Sansum Medical Research Foundation, Santa Barbara, Calif.

Footnotes
Reprint requests to Department of Obstetrics and Gynecology, University of Tennessee, Memphis, 800 Madison Ave, Memphis, TN 38163 (Dr Simpson).

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