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Background Aim Materials and Methods Results Conclusion Symptoms like vaginal bleeding or abdominal pain in early pregnancy can create anxiety about potential miscarriage. Previous studies have demonstrated ultrasonographic variables at the first trimester transvaginal scan (TVS) which can assist in predicting outcomes by 12 weeks gestation.To validate the miscarriage risk prediction model (MRP) in women who present with a viable intrauterine pregnancy (IUP) at the primary ultrasound.A multi‐centre diagnostic study of 1490 patients was performed between 2011 and 2019 for retrospective external and 2017–2019 for prospective temporal validation. The reference standard was a viable pregnancy at 12 + 6 weeks. The MRP model is a multinomial logistic regression model based on maternal age, embryonic heart rate, logarithm (gestational sac volume/crown‐rump length (CRL)) ratio, CRL and presence or absence of clots.Temporal validation data from 290 viable IUPs were collected: 225 were viable at the end of the first trimester, 31 had miscarried and 34 were lost to follow‐up. External validation data from 1203 viable IUPs were collected at two other ultrasound units: 1062 were viable, 69 had miscarried and 72 were lost to follow‐up. Temporal validation with a cut‐off of 0.1 demonstrated: area under the curve (AUC) of 0.8 (0.7–0.9), sensitivity 66.7%, specificity 83.9%, positive predictive value (PPV) 35.7%, negative predictive value (NPV) 94.9%, positive likelihood ration (LR+) 4.1 and negative LR (LR−) 0.4. External validation demonstrated: AUC 0.7 (0.7–0.8), sensitivity 44.9%, specificity 90.4%, PPV 23.3%, NPV 96.2%, LR+ 4.6 and LR− 0.6 (0.4–0.7).The MRP model is not able to be used in real time for counselling, and management should be individualised. [ABSTRACT FROM AUTHOR]

Objectives: Does cigarette smoking impact the embryonic growth rate in the first trimester? Methods: This is a retrospective multicentre observational study of 2912 pregnancies. Women who presented to the early pregnancy and perinatal ultrasound units between 2010 and 2019 were included in the study. The data collected included the following: smoking status, the crown–rump length (CRL) of the pregnancy at the first ultrasound that showed an embryonic heart rate, the gestation in days and the CRL at another ultrasound up to the nuchal translucency scan and the gestation in days. Additional demographic data included the following: age, weight, height, parity and mode of delivery. Of the 2912, complete smoking and demographic data were available for 657 pregnancies. One hundred and thirty‐seven (26.3%) were smokers, and 520 (73.7%) were not. The rate of change of smokers vs non‐smokers between two CRLs and two different days of gestation was calculated. The Wilcoxon rank sum test with continuity correction was used for statistical analysis. Results: This gives a value of W = 31,940 and a P‐value = 0.06. There is a slight shift in location for the smokers; however, it is not statistically significant. The insignificance may be due to the general large variance in growth rate. Conclusion: The impact of cigarette smoking on embryonic growth rate detected by CRL in the first trimester is statistically insignificant. [ABSTRACT FROM AUTHOR]