Diagnostic Ultrasound - Abdomen and Pelvis

Failed First Trimester Pregnancy
Diagnoses: Female Pelvis
(Left) Transverse transvaginal
color Doppler ultrasound in a
patient with embryonic demise
shows lack of embryonic
vascular flow, supporting this
diagnosis. (Right) Transverse
transvaginal ultrasound shows
yolk sac abnormalities, which
indicate a poor prognosis for
this pregnancy. A small
calcified YS ſt is seen
separated from the embryo by
a thin stalk st, termed, the
yolk stalk sign.
(Left) Transverse transvaginal
ultrasound shows an enlarged
yolk sac (9 mm) with a thin
wall ſt, findings suggesting a
guarded prognosis. Note the
tiny embryo st growing on
the yolk sac. Though cardiac
activity was not seen, the
embryo is below < 7 mm, and
follow-up was recommended.
(Right) Magnified view of a
gestational sac shows an
enlarged yolk sac with
irregular wall thickening,
which are poor prognostic
features.
(Left) Longitudinal
transvaginal ultrasound of the
uterus shows a small amount
of nonspecific, centrallylocated
fluid ſt in the
endometrial cavity in the
setting of a failed intrauterine
pregnancy. (Right) Compared
to the previous image, the
intradecidual sac sign of early
intrauterine pregnancy is a
small, round collection st
with an echogenic rim,
eccentrically located in the
thickened decidua. Often
absent, this sign is not
required for diagnosis of an
IUP.
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