Failed early pregnancy | Radiology Reference Article | Radiopaedia.org (2024)

Last revised by Yoshi Yu on 13 May 2023

Citation, DOI, disclosures and article data

Citation:

Jones J, Yu Y, Yap J, et al. Failed early pregnancy. Reference article, Radiopaedia.org (Accessed on 08 Apr 2024) https://doi.org/10.53347/rID-9040

rID:

9040

Disclosures:

At the time the article was created Jeremy Jones had no recorded disclosures.

View Jeremy Jones's current disclosures

Last revised:

13 May 2023, Yoshi Yu

Disclosures:

At the time the article was last revised Yoshi Yu had no financial relationships to ineligible companies to disclose.

View Yoshi Yu's current disclosures

Revisions:

32 times, by 18 contributors - see full revision history and disclosures

Systems:

Synonyms:

  • Embryonal death
  • Embryonic death
  • Embryonic demise
  • Embryonal demise
  • Non-viable early pregnancy
  • Failed early gestation
  • Non viable early gestation

Failed early pregnancy(sometimes termed embryonic demise) refers to the death of the embryo and therefore, miscarriage. The most common cause of embryonic death is a chromosomal abnormality.

On this page:

Article:

  • Radiographic features
  • Practical points
  • See also
  • References

Images:

  • Cases and figures

Radiographic features

Ultrasound
Findings diagnostic of pregnancy failure
  • crown-rump length (CRL) of ≥7mm and no heartbeat on a transvagin*l scan 3

  • mean sac diameter (MSD) of ≥25mm and no embryo on a transvagin*l scan 3

  • absence of embryo with heartbeat ≥2 weeks after a scan that showed a gestational sac without a yolk sac

  • absence of embryo with heartbeat ≥11 days after a scan that showed a gestational sac with a yolk sac

  • sac with no embryo and an MSD <12 mm on initial scan that fails to double in size on a scan ≥14 days later 2

  • sac with no embryo and an MSD ≥12 mm on initial scan with no embryo heart activity on a scan ≥7 days later 2

  • embryo (irrespective of crown-rump length) without cardiac activity on initial scan and on repeat scan ≥7 days later 2

  • cessation of a previously documented cardiac activity of embryo (irrespective of crown-rump length)

Findings suspicious but not diagnostic of pregnancy failure
  • crown-rump length (CRL) of <7 mm and no heartbeat

  • mean sac diameter (MSD) of 16-24 mm and no embryo

  • absence of embryo with heartbeat 7-13 days after a scan that showed a gestational sac without a yolk sac

  • absence of embryo with heartbeat 7-10 days after a scan that showed a gestational sac with a yolk sac

  • absence of embryo ≥6 weeks after last menstrual period

  • absence of embryo when amnion seen adjacent to yolk sac (empty amnion sign)

  • embryo present with amnion visible around it but no heartbeat (expanded amnion sign)

  • yolk sac that is separated from an embryo when CRL is ≤ 5 mm (yolk stalk sign)

  • small gestational sac in relation to the size of the embryo (<5 mm difference between mean sac diameter and crown-rump length)

  • enlarged yolk sac (>7 mm)

Practical points

When there are findings suspicious for pregnancy failure, follow-up ultrasonography at 7-14 days to assess the pregnancy for viability is generally appropriate.

See also

Quiz questions

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Failed early pregnancy | Radiology Reference Article | Radiopaedia.org (2024)

FAQs

What is commonly referred to as early pregnancy failure? ›

The loss of a pregnancy before 13 completed weeks is called early pregnancy loss. It also may be called a miscarriage or spontaneous abortion.

What is the criteria for failed early pregnancy? ›

Early pregnancy loss is defined as a nonviable, intrauterine pregnancy with either an empty gestational sac or a gestational sac containing an embryo or fetus without fetal heart activity within the first 12 6/7 weeks of gestation 1.

What are the SRU guidelines for failed pregnancy? ›

The SRU has presented specific guidelines for diagnosing pregnancy failure based on certain characteristics: namely, (1) the CRL measurement by which an embryonic heart rate must be identified (7 mm), (2) the MSD by which an embryo should be identified (25 mm), and (3) the absence of an embryo in two consecutive ...

Why early pregnancy failure? ›

The number of chromosomes the fetus has—too many or too few—can affect survival. Other possible causes of pregnancy loss include: Being exposed to toxins in the environment. Problems of the placenta, cervix, or uterus.

What is the difference between a failed pregnancy and a miscarriage? ›

In medical terms, early miscarriage is called an early pregnancy failure. This means that the pregnancy failed to develop. Almost all early miscarriages are due to circ*mstances beyond anyone's control, and were destined to happen before the woman even knows she is pregnant.

What week is the highest risk of miscarriage? ›

Most miscarriages - 8 out of 10 (80 percent) - happen in the first trimester before the 12th week of pregnancy. Miscarriage in the second trimester (between 13 and 19 weeks) happens in 1 to 5 in 100 (1 to 5 percent) pregnancies. Pregnancy loss that happens after 20 weeks is called stillbirth.

Can a failed pregnancy be misdiagnosed? ›

A misdiagnosed miscarriage occurs in scenarios where pregnant women are falsely informed that their baby has died in utero. Naturally, this can be a very distressing experience for the affected women and their families.

What is the treatment for a failed pregnancy? ›

The most common procedure is a dilation and curettage (D&C), which involves widening your cervix and scraping the uterine lining, or endometrium. Sometimes the doctor uses suction along with scraping. This procedure can be uncomfortable, so you'll probably get general anesthesia to put you to sleep if you need it.

What hCG level indicates miscarriage? ›

In the event of a miscarriage, hCG levels typically decrease from previous measurements. For example, a baseline level of 120 mIU/mL that's dropped to 80 mIU/mL two days later can indicate the embryo is no longer developing and the body isn't producing more hormones to support its growth.

What findings are suspicious for pregnancy failure radiology? ›

If an embryo is seen with a crown-rump length of <7 mm and without cardiac activity, it is suspicious for an early pregnancy loss (Figure 5). Similarly, a gestational sac with a mean sac diameter of 16-24 mm and no embryo is suspicious for an early pregnancy loss.

What happens after early pregnancy failure? ›

If you have had a miscarriage, the next pregnancy will usually be normal. After a miscarriage, the chance of you miscarrying again is low (1 in 5 women). If you have had 3 or more miscarriages, your doctor may recommend you that you see a fertility specialist.

What is the nice guideline for incomplete miscarriage? ›

For the management of miscarriage, the NICE guideline recommends 3 alternative strategies: surgical management, expectant management and medical management. The guideline currently recommends misoprostol for the medical treatment of missed or incomplete miscarriage (see recommendations 1.5. 10 to 1.5. 13).

Can you save a failing pregnancy? ›

In most cases, you cannot stop a miscarriage once it has started, no matter the trimester you are currently in. The symptoms of a miscarriage typically indicate the pregnancy is already over. In some cases, the symptoms may be a sign of a condition called threatened miscarriage.

Does your tummy still grow after a miscarriage? ›

These symptoms can be so profound in some women that it can seem like the miscarriage didn't even occur. They may include: Abdominal enlargement with increased firmness. Bloating and gas.

Can hitting the cervix cause a miscarriage? ›

Can Sex Harm My Baby? No. Your baby is fully protected by the amniotic sac (a thin-walled bag that holds the fetus and surrounding fluid) and the strong muscles of the uterus. There's also a thick mucus plug that seals the cervix and helps guard against infection.

What is failure to progress in pregnancy? ›

Definition. Failure to progress (FTP) happens when labor slows and delays delivery of the baby. The cervix may not thin and open as it should. This makes it hard for the baby to move down the birth canal.

What is an early term miscarriage called? ›

A chemical pregnancy is a very early miscarriage. They can happen before you know that you're pregnant. The egg is fertilised but loss happens soon after implantation, so it'll never have a heartbeat. You won't usually have signs of anything happening with a chemical pregnancy.

What is the medical term for early pregnancy? ›

Prenatal – a term meaning 'before birth' (alternative terms are 'antenatal' and 'antepartum').

What is fetal failure? ›

: causing ruin or failure. She made a fatal mistake/error. The plan contained a fatal flaw. [=a flaw that would cause it to fail] a fatal weakness.

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