Failed early pregnancy
Updates to Article Attributes
Body
was changed:
Failed early pregnancy refers to the death of the embryo and therefore, miscarriage. The most common cause of embryonic death is a chromosomal abnormality.
Radiographic features
Ultrasound
Findings diagnostic of pregnancy failure
- crown-rump length (CRL) of ≥7 mm and no heartbeat on a transvaginal scan
- mean sac diameter (MSD) of ≥25 mm and no embryo on a transvaginal scan
- absence of embryo with heartbeat ≥2 weeks after a scan that showed a gestational sac without a yolk sac
- absence of embryo with heartbeat ≥11 days after a scan that showed a gestational sac with a yolk sac
- sac with no embryo and an MSD <12 mm on initial scan that fails to double in size on a scan ≥14 days later 2
- sac with no embryo and an MSD ≥12 mm on initial scan with no embryo heart activity on a scan ≥7 days later 2
- embryo (irrespective of crown-rump length) without cardiac activity on initial scan and on repeat scan ≥7 days later 2
- cessation of a previously documented cardiac activity of embryo (irrespective of crown-rump length)
Findings suspicious but not diagnostic of pregnancy failure
- crown-rump length (CRL) of <7 mm and no heartbeat
- mean sac diameter (MSD) of 16-24 mm and no embryo
- absence of embryo with heartbeat 7-13 days after a scan that showed a gestational sac without a yolk sac
- absence of embryo with heartbeat 7-10 days after a scan that showed a gestational sac with a yolk sac
- absence of embryo ≥6 weeks after last menstrual period
-
absence of embryo when amnion seen adjacent to yolk sac
, with no visible embryo(empty amnion sign) -
enlarged yolk sacembryo present with amnion visible around it but no heartbeat (>7 mmexpanded amnion sign) - small gestational sac in relation to the size of the embryo (<5 mm difference between mean sac diameter and crown-rump length)
-
embryo with no heartbeat with amnion visible around itenlarged yolk sac (>7 mm)expanded amnion sign
Practical points
When there are findings suspicious for pregnancy failure, follow-up ultrasonography at 7-14 days to assess the pregnancy for viability is generally appropriate.
See also
-<li>amnion seen adjacent to yolk sac, with no visible embryo (<a href="/articles/empty-amnion-sign">empty amnion sign</a>)</li>-<li>enlarged yolk sac (>7 mm)</li>- +<li>absence of embryo when amnion seen adjacent to yolk sac (<a href="/articles/empty-amnion-sign">empty amnion sign</a>)</li>
- +<li>embryo present with amnion visible around it but no heartbeat (<a href="/articles/expanded-amnion-sign">expanded amnion sign</a>)</li>
-<li>embryo with no heartbeat with amnion visible around it (<a href="/articles/expanded-amnion-sign">expanded amnion sign</a>)</li>- +<li>enlarged yolk sac (>7 mm)</li>