What is an intrauterine pregnancy of uncertain viability (IPUV)?

IPUV is a term we use to describe a pregnancy that has been scanned at a stage where we cannot be sure whether it is developing normally or not. While we are able to confirm that the pregnancy is in the womb, the pregnancy sac is either too small to expect to see an embryo, or the embryo is seen but is too small for us to expect to see a heartbeat.

How common is IPUV?

This situation is not uncommon and happens in around one in five women attending for a scan in an early pregnancy unit.

What is the likely diagnosis?

There are two possible outcomes after a diagnosis of IPUV. These are:

  • The first scan was performed too early and the pregnancy will progress normally.
  • The pregnancy will not progress normally and sadly, we are able to confirm a miscarriage.

What will happen next?

You will have been asked to attend the unit for a further scan and assessment after a period of 7-14 days (depending on what we saw during the first scan). We know this will be an anxious wait for you, but performing another scan earlier may lead to another inconclusive result, which would be unhelpful and may raise your anxiety further.

What should I do if I have problems before my next appointment?

An ultrasound diagnosis of an IPUV may be the first sign that the pregnancy is not progressing normally. Therefore it is possible that pain and bleeding will develop and lead to a miscarriage before you attend your next appointment.

If this pain and bleeding is manageable, we would advise you to stay at home where you will be most comfortable. Sadly, we are not able to prevent a miscarriage from happening.

If you miscarry at home or somewhere outside of the hospital, you may pass the remains of the pregnancy into the toilet. You may see a pregnancy sac and/or a fetus. You may want to simply flush the toilet, which many people do automatically or you may want to remove the tissue for a closer look. You may decide to bury the remains yourself or you can bring them into our unit for us to look at and take care of. You can ask us more about this.

If you have any of the following symptoms, please attend your local emergency department:

  • severe lower abdominal pain which is not controlled by over the counter pain medication (such as paracetamol)
  • heavy vaginal bleeding with large clots (especially if you are soaking through two large sanitary pads per hour for more than two hours)
  • if you feel unwell or are worried by anything that is happening to you and do not feel that you can cope at home

Whether or not you experience vaginal bleeding, please attend your next scan as planned. If you have any questions, please feel free to contact us using the following numbers.