Presentation
Early pregnancy ultrasound for dating and viability.
Patient Data
Age: 40 years
Gender: Female
From the case:
Pregnancy of uncertain viability with large yolk sac
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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.
Case Discussion
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.
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