Missed miscarriage with echogenic yolk sac

Case contributed by Dr Alexandra Stanislavsky


PV bleeding in early pregnancy

Patient Data

Age: 30 years
Gender: Female

An intrauterine gestational sac is identified, with mean sac diameter of 16mm. A 9mm fetal pole is measured, with no cardiac activity detected. A contracted, echogenic yolk sac is noted, which is a poor prognostic factor and there is a perigestational hemorrhage measuring 19 x 21mm. The cervix is closed. Corpus luteum noted in the left ovary.


Case Discussion

Absence of fetal cardiac activity in a 9mm embryo is diagnostic of fetal demise (missed miscarriage).

Abnormal appearance of a yolk sac in early pregnancy is commonly associated with poor pregnancy outcomes.  Specifically, an echogenic or calcified yolk sac is almost invariably seen in the setting of early fetal demise.

Perigestational hemorrhage is also considered a poor prognostic factor, but with a much less grim outlook - many early pregnancies with perigestational hemorrhage progress to normal outcome. 

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Case information

rID: 61565
Published: 11th Nov 2018
Last edited: 15th May 2019
System: Obstetrics
Inclusion in quiz mode: Included

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