Missed miscarriage with echogenic yolk sac
PV bleeding in early pregnancy
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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.
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.