Understanding a Collapsing Gestational Sac: What to Expect After a Vaginal Ultrasound

Question
My daughter is 7 weeks along. She had a vaginal ultra sound done. The mid-wife could not hear a heart beat, and said the sac was collapsing. They are doing more hormone tests to see if they have doubled and will do another ultra sound next week. I could not find any information  to explain why the sac is collapsing.  God Bless you for your wonderful work and time!!!!!

Answer
Dear Dee,

An irregularly shaped gestational sac on ultrasound can indicate a few things. It may be that there is some bleeding that is adjacent to the pregnancy that has caused the distortion, sometimes there has been compression by another pregnancy that is not developing (vanishing twin), or often the early placenta is not forming correctly, leading to a "collapse" of the sac. Getting additional hCG levels to make sure they are doubling in a 48-72 hour period sounds absolutely appropriate. If they are not doubling or are falling, that would indicate a problem with the pregnancy and, in consideration of the absent heart activity on ultrasound at 7 weeks, a probable pregnancy loss and imminent miscarriage.

I hope this has helped you and answered your question. I wish you and your daughter well and will have a good thought for you.

Brenda