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Objective. The etiology of embryonic demise is multifactorial, with chromosomal abnormalities being the most common (40%). The purpose of this study is to evaluate the correlation between a serum biomarker, inhibine A, and an ultrasonographic parameter, the distance between yolk sac (YS) and embryo (DYSE), in assessing the prognosis of pregnancy evolutivity in the first trimester. Method. The study is a case-control prospective analysis that includes two groups of patients: 81 patients with first-trimester pregnancy in evolution, 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 inhibin A 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 inhibin A values, statistically significant differences were observed between the two groups (p<0.05). Conclusions. DYSE has a high positive predictive value in identifying pregnancies with potentially reserved evolutivity, this study demonstrating that a DYSE<3 mm may lead to an unfavorable evolution of pregnancy. The low serum level of inhibine A is associated with an increased rate of non-viable embryos. [ABSTRACT FROM AUTHOR]

The vitelline duct is the structure that can be visualized early inside the gestational sac, allowing the ultrasound diagnosis of intrauterine pregnancy. Embryological aspects. The vitelline duct begins to form at approximately 14 days post-conception. In the fourth week of embryological development, the vitelline duct wall consists of three thin cell layers: the outer layer (the ectoderm); the inner layer, lined by the endodermal epithelium; the mesodermal layer, consisting of island blood formations where hematopoietic stem cells can be identified. Aspects of 2D ultrasound. The ultrasound aspect of the vitelline duct initially appears as two parallel lines. Subsequently, from 5.5 weeks it appears as a round, transonic structure, with a diameter of 3-5 mm. Certain ultrasound parameters of the vitelline duct can be described, which can be used to evaluate the evolutionary prognosis of the pregnancy: early visualization, dimensions, number, form, persistence of visualization in the second trimester, calcification. Aspects of 3D ultrasound. Performing the volumetry of the vitelline duct allows a more accurate estimation of the relationship between the vitelline duct and the volume of the gestational sac, as well as the correlation between the volume of the vitelline duct and the cranial- caudal length of the embryo. The VOCAL method allows a detailed evaluation of the external surface of the vitelline duct. Aspects of Doppler ultrasound. The vascularization of the vitelline duct is related to the intervillous circulation and plays an essential role in the early maternal-embryonic exchange. Under normal conditions, the velocimetry profile of the vitelline duct is characterized by: low velocity, absence of diastolic flow, the average IP value of 3.24. In a pregnancy with reserved evolutionary potential, the vascular flow is characterized by: irregular vascular flow, permanent diastolic flow, signs of venous blood flow. The combination of 2D, 3D and Doppler ultrasound allows the identification of important moments in the development of pregnancy, allowing at the same time the thoroughgoing study of physiological and physiopathological mechanisms, characteristic of the first trimester pregnancy. [ABSTRACT FROM AUTHOR]