Evolution of the amniotic sac and extracelomic space as seen by early ultrasound examination.

Objective: Amniotic sac and extracelomic space changes occurring from 5 to 14 weeks of pregnancy were observed with transvaginal ultrasound to gain new insights into their normal relationships during this time period.

Study Design: Ninety-seven women from 5 to 15 weeks' gestation were enrolled in the study. Gestational age was determined by measuring embryonic crown-rump length. The embryo, amniotic sac, and gestational sac areas were measured using the best-fitted computer-generated elliptical view. The embryonic heart rate was measured using the M-mode function of the ultrasound equipment. Associations were determined using the least-squares method and Pearson's correlation coefficient.

Results: Mean (range) gestational age calculated from CRL was 9.6 (5.3-14.6) weeks, embryonic heart rate 153 (100-188) beats per minute, embryonic surface 699.6 (5-2,199) mm(2), amniotic sac surface 1,383 (5-5,335) mm(2) and gestational sac surface was 1,517 (110-5,335) mm(2). Significant correlations between gestational sac surface, amniotic sac surface, embryonic surface, heart rate and gestational age were noted (p < 0.01). Changes in the amniotic sac surface correlated with embryonic surface but not with heart rate even when multiple regression analysis was attempted.

Conclusion: These data describe the normal relationships between the embryonic, amniotic sac, extracelomic space, and gestational sac surface, suggesting that increases in embryonic surface area is a determining factor for early expansion of the amniotic sac at these gestational ages.