Presentation
The patient presented for a follow-up scan two weeks after an initial scan at 6 weeks. She reported spotting per vaginum that was present during the initial scan but has since reduced, with no pain or tenderness.
Patient Data
An intrauterine gestational sac was seen. The decidual reaction is adequate.
The estimated gestational age by mean sac diameter (MSD) was 6 weeks 4 days.
No yolk sac or fetal pole were seen.
There was a small subchorionic bleed superior to the gestational sac.
There is an irregular intrauterine gestational sac.
No yolk sac or fetal pole were seen.
A note is made of a serial increase in the amount of subchorionic hemorrhage.
Case Discussion
Failed early pregnancy refers to a pregnancy that has no evidence of current or expected viability sonographically, ultimately leading to a miscarriage.
This is confirmed by sonography in a follow-up scan, often after two weeks, with features like:
absence of an embryo with a heartbeat greater than two weeks after a scan that showed an intrauterine sac
sac is less than 12 mm in diameter with no embryo and fails to double in size two weeks later
Note should be made of the clinical presentation to rule out bleeding per vaginum that would be indicative of miscarriage.
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