Intrauterine Pregnancy of Uncertain Viability

What is an early intrauterine pregnancy of uncertain viability?

In some cases, a pregnancy sac is seen within the uterus (womb) on ultrasound scan, however an embryo (developing baby) or heartbeat is not visible. We call this an intrauterine pregnancy of uncertain viability.

Why could this be happening to me?

This can be a completely normal finding for some women as the pregnancy is just in the very early stages. It is also more likely if you are unsure of your last period dates, have irregular periods, recently stopped taking the contraceptive pill or were recently pregnant.

However, for some women this may not be a normal finding and could be a sign the pregnancy is not developing as expected. This may be the case if the size of the pregnancy is less than expected for your last period (if you have regular periods) and/or if you are having symptoms of vaginal bleeding.

What happens next?

For a significant number of women if your pregnancy is consistent with your gestational date and otherwise progressing normally, we recommended booking antenatal care and further scans as per your expected pregnancy schedule. We also usually discharge you from the Early Pregnancy Unit at this stage with advice on when to call us again with new concerns. For other women a rescan in up to 2 weeks to confirm viability (normal development) of the pregnancy is needed. This interval gives your pregnancy time to develop before we rescan you. The decision for a rescan and specifically when it occurs is according to our protocols. Our protocols take into account your clinical history, our ultrasound findings and any prior written ultrasound reports you have for this pregnancy.

What if I have bleeding?

Vaginal bleeding in pregnancy in early pregnancy is common.  This does not mean that your pregnancy is not going to progress normally.  If your bleeding is no worse than before you had your first ultrasound scan with us, then wait to attend your planned rescan appointment, if that was our advice.

However, unfortunately, bleeding does increase your risk of miscarriage. So if your bleeding gets worse you can call us for advice or attend A&E if it is heavy (i.e. if you need to change a soaked sanitary pad or more every hour).

We do not advise flying if your pregnancy is complicated with vaginal bleeding for any reason. This is because there is also a chance you may miscarry before your next review.

How do I know if I am having a miscarriage?

You will have bleeding, usually heavy with clots, as well as lower abdominal cramps or contraction-like pains.

What should I do if I am miscarrying?

If the bleeding becomes heavy or is accompanied by abdominal pain or if you are worried, please call us for advice (our phone numbers are below). If bleeding or pain is severe and/or you feel unwell in any way you should attend your nearest Emergency Department, as you may need to have urgent surgery. Unfortunately, there is nothing that can be done to stop these miscarriages.

If required, you can take painkillers you are not allergic to, such as Paracetamol / codeine to ease the pain and let the miscarriage happen naturally. At your next review, you can ask us any further questions you may have.

Who can I contact with queries and concerns?

Elizabeth Suite (Early Pregnancy and Emergency Gynaecology Unit)

0203 315 5073 (admin queries only 9-12pm & 2-4pm Mon-Fri).

0203 315 5070 (clinical queries only 12-2pm Mon-Fri).

Outside of these working hours please attend your nearest Accident & Emergency Department with any of the concerns described above.