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Age: 33

Sex: Female

Indication: Pregnant, vaginal bleeding

Gestational age: 6 weeks

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Case #10


Findings

  • A single intrauterine gestational sac is identified with mean sac diameter measuring 15 mm
  • A fetal pole is present with crown-rump length measuring 6 mm, corresponding to an estimated gestational age of 6 weeks, 3 days
  • No cardiac contractions are seen
  • Normal appearance of the uterus and ovaries
  • No free fluid in the cul-de-sac


Diagnosis

Suspicious for pregnancy failure

Sample Report

Single intrauterine gestational with findings suspicious for, but not diagnostic of pregnancy failure given a crown-rump length measurement of 6 mm without detectable cardiac contractions. Recommend trending beta-hCG values and repeat ultrasound in 7-10 days. Crown-rump length measurement corresponds with an estimated gestational age of 6 weeks, 3 days.

Normal appearance of the uterus and ovaries.


Discussion

  • A visible fetal pole measuring < 7 mm without detectable cardiac contractions is suspicious for, but not diagnostic of pregnancy failure
  • Other findings suspicious for pregnancy failure include:
    • Means sac diameter measuring 16-24 mm without fetal pole
    • Yolk sac measuring > 7 mm
    • Empty amnion
    • Absence of an intrauterine gestational sac > 6 weeks after last menstrual period
    • Absence of embryo with a heartbeat 10 days after a scan showing a gestational sac with a yolk sac OR 13 days after a scan showing a gestational sac without a yolk sac
    • < 5 mm difference between mean sac diameter and crown-rump length



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