Anembryonic multiple pregnancy diagnosed by transvaginal ultrasound: a case report

Abstract

Background: First-trimester vaginal bleeding is a common reason for emergency consultation, affecting approximately 15–25% of pregnancies. Its causes include threatened miscarriage, spontaneous abortion, and early developmental abnormalities such as anembryonic pregnancy. Multiple anembryonic gestations are rare and pose diagnostic and therapeutic challenges. Case presentation: An 18-year-old patient presented with severe lower abdominal pain lasting three days, associated with mild vaginal bleeding that worsened hours before consultation. Transvaginal ultrasound revealed four gestational sacs without embryos or yolk sacs, consistent with multiple anembryonic pregnancy. Medical management with misoprostol was initiated, followed by manual vacuum aspiration, with a favorable outcome. Conclusions: Multiple anembryonic pregnancy is an uncommon condition that requires early and accurate ultrasound diagnosis. Prompt transvaginal ultrasound assessment is essential to guide management and reduce complications in first-trimester bleeding.