Pregnancy of uncertain viability with large yolk sac

Case contributed by Alexandra Stanislavsky


Early pregnancy ultrasound for dating and viability.

Patient Data

Age: 40 years
Gender: Female

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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