please suggest ,missed cardiac activity at 9th weak ,what to suggest to patients

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Termination Misoprostol tab 400 mcg vaginally every 4 hours for upto six doses. May need suction evacuation of retained products. Give anti D if mother is rh negative.

D & E
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If no cardiac activity then u have to declare it to be Missed Abortion. Go for D&E after counselling.

Repeat usg for confirmation Suction and evacuation Rule out thyroid disorder and diabetic profile to find the cause

Usg scan suggest minimal perigestational bleed and if there is history of bleeding per vagina then it is embryo demise. Go for the termination either medical or D&C.

By 9 weeks cardiac activity should have appeared. Take one more openion.If same report go for termination.

Advice USG from another centre. If report same then advice evacuation

Termination

No cardiac activity?? It is missed abortion , we can give her one chance to conform so we can ad one more usg from anther centre then u decide and suggest for D&e

One more usg opinion if same report then go for D& E

Termination of pregnancy

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