Sonographic findings definitive for failed intrauterine pregnancy include crown-rump length (CRL) of at least 7 mm without cardiac activity, mean sac diameter (MSD) of at least 25 mm without an embryo, and no embryo with a heartbeat on a follow-up scan at specific time intervals after the initial scan. In a woman with a positive pregnancy test, any round or oval intrauterine fluid collection should be interpreted as highly likely to be a gestational sac, not a pseudogestational sac or decidual cyst, and treatments that could damage an intrauterine pregnancy should be avoided.Īn extraovarian mass can be distinguished from an intraovarian lesion, such as a corpus luteum, by observing its motion relative to the ovary when pressure is applied by the transvaginal transducer. In a woman with a positive pregnancy test and no evidence of an intrauterine or ectopic pregnancy on ultrasound (pregnancy of unknown location ), a single hCG measurement does not reliably distinguish a normal intrauterine pregnancy from a failed intrauterine pregnancy or an ectopic pregnancy. The progression of transvaginal sonographic findings in normal early first trimester pregnancies follows a highly predictable pattern, with a gestational age variability of approximately ☐.5 week: gestational sac at 5.0 weeks, yolk sac at 5.5 weeks, embryo with heartbeat at 6.0 weeks, and amnion at 7.0 weeks. Small Gestational Sac Size in Relation to the Embryo, 93 Risk Factors for Impending Pregnancy Failure When Embryonic Heartbeat Is Seen, 91 Time-Based Criteria Suspicious for Pregnancy Failure, 90 Sonographic Findings Suspicious (but Not Definitive) for Failed Intrauterine Pregnancy, 90Ĭrown-Rump Length With No Embryonic Heartbeat, 90 Time-Based Criteria for Pregnancy Failure, 89 Sonographic Findings Definitive for Failed Intrauterine Pregnancy, 88Ĭrown-Rump Length With No Embryonic Heartbeat, 88 Ultrasound Demonstrates a Complex or Solid Adnexal Mass, 87Īssignment of Gestational Age by Early First Trimester Ultrasound, 87ĭiagnosis of Failed Intrauterine Pregnancy (Miscarriage), 88 Ultrasound Demonstrates an Intrauterine Fluid Collection and No Adnexal Abnormality, 85 Ultrasound Demonstrates No Intrauterine Fluid Collection and No Adnexal Abnormality (No Extraovarian Adnexal Mass or Significant Free Fluid), 84 Normal Transvaginal Sonographic Findings in the Early First Trimester, 83Ĭonfirmation or Exclusion of Intrauterine Pregnancy When No Yolk Sac or Embryo Is Seen, 84
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