A p2 +1 female comes with amenorrhea of 5 weeks. Her UPT is +ve. On USG, Gestational and yolk sac are seen in uterus. No fetal pole is visible.No fatal cardiac activity is seen. CRl is 8mm and MSD= 28 mm. What is the next best step?
In a normal ble pregnancy gestational sac appears at 4.5 weeks,yolk sac at 5 week,fetal node at 5.5 week,fetal hea at 6 week.In this case fetal pole and fetal cardiac activity cannot be detected even at 5 th week.So it suugests high probability of non ble pregnancy and sholud wait for 7 days and repeat the USG. For more details ,refer page no 475 of text book of obsteics,sheila balakrishnan,2 nd edition.
Advise MTP as it is nonble pregnancy
High probability of nonble pregnancy- but still repeat scan after 7 days to confir mg
c. Can be ectopic pregnancy -- give methotrexate
d. High probability of ble pregnancy-repeat scan after 7 days
General obstetrics