Pregnancy of uncertain viability with large yolk sac
Early pregnancy ultrasound for dating and viability.
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Intrauterine gestational sac containing a fetal pole with CRL 6.1mm. No cardiac activity was detected.
The yolk sac is enlarged, at 8.4mm.
This is essentially a pregnancy of uncertain viability (PUV), and should be followed up to establish fetal viability. However the large yolk (8mm where n<6mm) is a poor prognostic factor, increasing the likelihood that this pregnancy will not progress.
There is also some evidence which suggests increased risk of abnormal karyotype in viable gestations where there was an initial finding of an enlarged yolk sac1. At the time of writing, there is no defined guideline regarding follow-up of such pregnancies.
- Tan S, Pektaş MK, Arslan H. Sonographic evaluation of the yolk sac. (2012) Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 31 (1): 87-95. Pubmed
- Gersak K, Veble A, Mulla ZD, Plavsic SK. Association between increased yolk sac diameter and abnormal karyotypes. (2012) Journal of perinatal medicine. 40 (3): 251-4. doi:10.1515/jpm.2011.140 - Pubmed