*22 year-old healthy female with early pregnancy.
What is the most likely diagnosis?
1. Anembryonic pregnancy
2. Wolffian duct cyst
3. Mullerian duct cyst
4. Uterine abscess
Answer
Answer: Anembryonic pregnancy
Case Discussion:
Ultrasound and Doppler ultrasound images showed an 8-week gestational sac without fetus.
An anembryonic pregnancy (also known as a blighted ovum) is a gestational sac which develops without an embryo. It is a cause of miscarriage (1). An embryo should be present at about six weeks of pregnancy. The gestational sac is ≥16 mm on TVS, or ≥25 mm on TAS at this time. In anembryonic pregnancy, the gestational sac forms and grows, however the embryo does not develop (2).
References:
1. Campion, Edward W.; Doubilet, Peter M.; Benson, Carol B.; Bourne, Tom; Blaivas, Michael. “Diagnostic Criteria for Nonviable Pregnancy Early in the First Trimester”. New England Journal of Medicine 2013;369 (15): 1443–1451.
2. Dogra V, Paspulati RM, Bhatt S. First trimester bleeding evaluation. Ultrasound Q. 2005;21 (2): 69-85.