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Five-Millimeter and Smaller Embryos Without Embryonic Cardiac Activity

Outcomes in Women With Vaginal Bleeding

Department of Radiology, University of California, San Francisco, California USA (S.A., C.C., R.A.F.); Moran, Rowen & Dorsey, Inc, Diagnostic Medical Imaging, Orange, California USA (R.C.C.); and California Advanced Imaging Medical Associates, Mills-Peninsula Health Services, Burlingame, California USA (D.B.B.).

Address correspondence to Richard C. Cho, MD, Department of Radiology, St Joseph Hospital, 1100 W Stewart Dr, Orange, CA 92868 USA.

Objective. The purpose of this study was to assess outcomes in embryos with a crown-rump length (CRL) of 5 mm or less without embryonic cardiac activity (ECA) among pregnant women with vaginal bleeding in the first trimester. Methods. A retrospective study of all first-trimester sonograms in women with vaginal bleeding from 1999 to 2002 was conducted. Results. Thirty-seven embryos without detectable ECA that had a CRL of 5 mm or less were identified. All resulted in pregnancy failure. The breakdown of these embryos by CRL was as follows: 13 were 5 mm; 10 ranged from 4 to 4.9 mm; 11 ranged from 3 to 3.9 mm; and 3 ranged from 2 to 2.9 mm. Conclusions. In pregnant women with vaginal bleeding, embryos of 5 mm and smaller without a heartbeat all resulted in pregnancy failure.

Key Words: bleeding • embryo • sonography • threatened abortion

Abbreviations: CRL, crown-rump length • ECA, embryonic cardiac activity • UCSF, University of California, San Francisco