Failed early pregnancy

Case contributed by Luis Gerardo Duque F
Diagnosis certain

Presentation

Patient with a pregnancy of 11.6 weeks of gestation by date of last menstruation, consultation for pain in the hypogastrium and vaginal bleeding.

Patient Data

Age: 30 years
Gender: Female
ultrasound

Enlarged uterus.

The endometrial cavity is occupied by a gestational sac with lobulated edges, with dimensions of 47 x 28 x 33 mm for a gestational age of 8.6 weeks per mean diameter of the sac. Embryonic pole with a cranio-caudal length of 13 mm for a gestational age of 7.4 weeks, without identifying cardiac activity.

Adjacent to the embryonic pole, an anechoic ovoid image with well-defined, hyperechoic borders corresponding to the yolk sac with an approximate dimension in its longitudinal axis of 15 mm.

Case Discussion

There is an endometrial cavity occupied by a gestational sac. No cardiac activity is identified in an embryo with cranio-caudal length ≥7mm on transvaginal examination.

In addition to this, there are findings of poor prognosis such as an embryo present with visible amnion fluid around it, but without a heartbeat (expanded amnion sign) and an enlarged yolk sac (>7 mm).

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