Q. The sonography report says there is no cardiac activity in the fetus. What should be done?

Answered by
Dr. Sameer Kumar
and medically reviewed by Dr. Chithranjali Ravichandran
This is a premium question & answer published on Apr 10, 2021

Hi doctor,

The issue is after January, and my menstruation was missed. I checked at home using a pregnancy strip and saw a positive result. After that, I met a gynecologist. She took sonography and prescribed medicines to review again after 15 days. She did not find cardiac activity in the fetus. Today I met her, but she said no growth in the result. I can share all the reports.

I want your precious suggestion, thanks.



Welcome to

Thanks for the query.

Considering that your last menstrual period date was in January, so that makes you ten weeks and one day pregnant as of date today. But having gone through the latest ultrasound for a dating scan (attachments removed to protect the patient's identity) dated it shows that the mean gestational sac diameter is about 27 mm, corresponding to 7 weeks and four days with the presence of yolk sac, but no fetal cardiac activity.

This is a definitely failed pregnancy or termed as an anembryonic gestation, where the embryo is not formed at all. Ideally, by seven weeks, the crown-rump length is measurable, and a primitive fetal heartbeat is evident, but as of the date, you are already ten weeks and one day (by LMP), so it is evident that pregnancy stopped growing after seven weeks and four days.

I am afraid that you need to undergo a medical abortion by medical method for the same, or it is likely that it may be spontaneously aborted over the next few weeks.

This would be my opinion.



Hello doctor,

Any chance of it sustaining?



Welcome back to

I am afraid, as I mentioned, it is an anembryonic gestation without evidence of fetal pole and gestational sac diameter at 27 mm (7 weeks only). This is a failed pregnancy and would have to be aborted. It would be better if you plan for a medical abortion rather than a surgical one, as this is your first pregnancy. Also, there is apparently no chance of it growing further. However, if you wish to be further sure, then you can get serial beta hCG levels done 48 hours apart. If there is less than a 65% rise from the first hCG level, it would further confirm a failing pregnancy. This is a blood test that measures hCG levels, to be done 48 hours apart.


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