Journal of Ultrasound in Medicine, Vol 9, Issue 11 631-636, Copyright © 1990 by American Institute of Ultrasound in Medicine
Diagnosis of early embryonic demise by endovaginal sonography
D. L. Brown, D. S. Emerson, R. E. Felker, M. S. Cartier and W. C. Smith
Department of Radiology, University of Tennessee, Memphis.
To determine the embryonic size at which cardiac activity is always seen in
a normal early pregnancy, 398 endovaginal sonograms were evaluated in which
the gestational sac contained a yolk sac and/or embryo of less than or
equal to 12 mm in crown-rump length (CRL). In the 99 sonograms in which
there was a yolk sac but no identifiable embryo, cardiac activity was
absent in 75; 58 of these pregnancies progressed normally. Of the 299
sonograms where there was an identifiable embryo with CRL less than or
equal to 12 mm, cardiac activity was absent in 31; 29 of these were proven
to be failed pregnancies. In two cases the pregnancy progressed normally;
the CRL was 2 mm in one case and 4 mm in the other. We conclude that once
an embryo is seen by endovaginal sonography, the absence of cardiac
activity usually indicates embryonic demise. However, when cardiac activity
is absent, one should refrain from definitively diagnosing embryonic
demise, based on a single sonogram, if the CRL is less than 5 mm.
