Failed early pregnancy

Changed by Yuranga Weerakkody, 15 Apr 2015

Updates to Article Attributes

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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 assessment

Ultrasound
Findings diagnostic of pregnancy failure
  • crown-rump length (CRL) of ≥7 mm and no heartbeat
  • mean sac diameter (MSD) of ≥25 mm and no embryo
  • 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
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 week≥ 6 weeks after last menstrual period
  • empty amnion (amnion seen adjacent to yolk sac, with no visible embryo)
  • enlarged yolk sac (>7 mm)
  • small gestational sac in relation to the size of the embryo (<5 mm difference between mean sac diameter and crown-rump length)

Practical points

When there are findings suspicious for pregnancy failure, follow-up ultrasonography at 7-10 days to assess the pregnancy for viability is generally appropriate.

  • -<li>absence of embryo ≥6 week after last menstrual period</li>
  • +<li>absence of embryo ≥ 6 weeks after last menstrual period</li>

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