Role of Early Pregnancy Ultrasound Markers for Predicting Miscarriage: A Systematic Review

Abstract

Background: Miscarriage is a common complication of early pregnancy, and most losses usually occur during the first trimester. Ultrasound is basically the main imaging technique in the examination of early pregnancy, particularly transvaginal ultrasound (TVUS), and various sonographic markers have been also proposed as predictors of miscarriage as well.

Objective: The present review aimed to systematically summarised the evidence on early pregnancy ultrasound markers that were usually associated with miscarriage.

Methods: The systematic review was based on PRISMA guidelines. Moreover, an electronic databases literature search was conducted using PubMed, Google Scholar, Scopus, Embase and Springer for original studies published between 2016 and 2026. Ten studies met the inclusion criteria and were analysed for study design, population, sonographic findings, estimating ultrasound markers before 12 completed weeks of pregnancy and reporting miscarriage outcomes as well.

Results: Across the included studies, abnormal morphology of the gestational sac, abnormal yolk sac, decreased crown–rump length, fetal bradycardia, and subchorionic hematoma were risk factors that were consistently associated with a higher miscarriage rate.

Conclusion: The study concluded that early pregnancy ultrasound is of value for predicting miscarriage. Standardized criteria and combined use with clinical and biochemical markers might improve predictive accuracy.