Pregnancy is considered viable if it can potentially result in live birth
Nonviable pregnancy is one that will not result in live birth
Intrauterine pregnancy (IUP) of uncertain viability
Intrauterine gestational sac, no embryonic heartbeat but no definite signs of pregnancy failure on transvaginal ultrasound (TVUS)
Pregnancy of unknown location
Positive pregnancy test with no identifiable intra- or extrauterine gestational sac on TVUS
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Doubilet PM et al: First-trimester prognosis when an early gestational sac is seen on ultrasound imaging: logistic regression prediction model. j ultrasound med. 40(3):541-50, 2021
Jensen KK et al: Imaging of acute pelvic pain: pregnant (ectopic and first-trimester viability updated). Radiol Clin North Am. 58(2):347-61, 2020
Phillips CH et al: "Pseudogestational sac" and other 1980s-era concepts in early first-trimester ultrasound: are they still relevant today? J Ultrasound Med. 39(8):1547-51, 2020
Hashem A et al: The impact of incidental ultrasound finding of subchorionic and retroplacental hematoma in early pregnancy. J Obstet Gynaecol India. 69(1):43-9, 2019
Suguna B et al: Yolk sac size & shape as predictors of first trimester pregnancy outcome: a prospective observational study. J Gynecol Obstet Hum Reprod. 48(3):159-64, 2019
Wang PS et al: Ultrasound of the first trimester. Radiol Clin North Am. 57(3):617-33, 2019
Bahouth SM et al: US findings of first-trimester pregnancy radiographics fundamentals | online presentation. Radiographics. 38(7):2193-4, 2018
Phillips CH et al: First-trimester emergencies: a radiologist's perspective. Emerg Radiol. 25(1):61-72, 2018
Doubilet PM et al: Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med. 369(15):1443-51, 2013
Barnhart K et al: Pregnancy of unknown location: a consensus statement of nomenclature, definitions, and outcome. Fertil Steril. 95(3):857-66, 2011
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KEY FACTS
Terminology
Imaging
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TERMINOLOGY
Definitions
Pregnancy is considered viable if it can potentially result in live birth
Nonviable pregnancy is one that will not result in live birth
Intrauterine pregnancy (IUP) of uncertain viability
Intrauterine gestational sac, no embryonic heartbeat but no definite signs of pregnancy failure on transvaginal ultrasound (TVUS)
Pregnancy of unknown location
Positive pregnancy test with no identifiable intra- or extrauterine gestational sac on TVUS
IMAGING
General Features
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Reporting Tips
Selected References
Doubilet PM et al: First-trimester prognosis when an early gestational sac is seen on ultrasound imaging: logistic regression prediction model. j ultrasound med. 40(3):541-50, 2021
Jensen KK et al: Imaging of acute pelvic pain: pregnant (ectopic and first-trimester viability updated). Radiol Clin North Am. 58(2):347-61, 2020
Phillips CH et al: "Pseudogestational sac" and other 1980s-era concepts in early first-trimester ultrasound: are they still relevant today? J Ultrasound Med. 39(8):1547-51, 2020
Hashem A et al: The impact of incidental ultrasound finding of subchorionic and retroplacental hematoma in early pregnancy. J Obstet Gynaecol India. 69(1):43-9, 2019
Suguna B et al: Yolk sac size & shape as predictors of first trimester pregnancy outcome: a prospective observational study. J Gynecol Obstet Hum Reprod. 48(3):159-64, 2019
Wang PS et al: Ultrasound of the first trimester. Radiol Clin North Am. 57(3):617-33, 2019
Bahouth SM et al: US findings of first-trimester pregnancy radiographics fundamentals | online presentation. Radiographics. 38(7):2193-4, 2018
Phillips CH et al: First-trimester emergencies: a radiologist's perspective. Emerg Radiol. 25(1):61-72, 2018
Doubilet PM et al: Diagnostic criteria for nonviable pregnancy early in the first trimester. N Engl J Med. 369(15):1443-51, 2013
Barnhart K et al: Pregnancy of unknown location: a consensus statement of nomenclature, definitions, and outcome. Fertil Steril. 95(3):857-66, 2011
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