IUP: intrauterine pregnancy; CRL: crown-rump length; MSD: mean gestational sac diameter.
* Early pregnancy loss generally applies to pregnancy in the first trimester (ie, up to 12 6/7 weeks' gestation).
¶ The sequential development of pregnancy structures visible with ultrasound imaging in normal early pregnancy include gestational sac (in gestational week 4), yolk sac (in week 5), and embryonic pole (5 6/7 weeks), with cardiac activity (in week 6). Crown-rump length is a longitudinal measurement of the embryonic pole. Gestational age based on last menstrual period may be inaccurate; a detailed discussion of determining gestational age with ultrasound findings is presented in related UpToDate content.
Δ Discussion of the evaluation and management of ectopic pregnancy, including heterotopic pregnancy, and pregnancy of unknown location are presented in related UpToDate content.
◊ For patients who desire expedited treatment of pregnancy loss and who accept a small chance of interrupting a potentially viable pregnancy, definitive treatment for pregnancy loss can be considered with the following caveats:§ Patients with CRL <5 mm are advised to repeat imaging in 7 to 10 days to assess for embryonic growth and cardiac activity. Patients with MSD <16 mm are advised to repeat imaging closer to 14 days (rather than 7 to 10 days) to increase the chance of visualizing a live pregnancy.
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