Missed miscarriage

Case contributed by Ahmed Esawy


Presented to the emergency department with cramping and vaginal bleeding.

Patient Data

Age: 20 years
Gender: Female

Fetus without cardiac activity seen. Non-viable embryo floats in amniotic fluid with no movement tied by chorioamniotic cord. Echogenicity seen centrally. 

Case Discussion

Transvaginal ultrasonography was performed initially and showed a fetal pole with a crown-to-rump length consistent with a gestational age of approximately 9 weeks. The fetus in a missed  miscarriage shows decreased size as a result of disintegration, lysis and loss of fluid content. Even intrafetal intravascular intracardiac gas is present, which presents as echogenic foci.

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