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A transvaginal ultrasound can detect a heartbeat with very high accuracy as early as six or seven weeks into a pregnancy. If performed properly, the results are considered accurate and reliable.
Once the fetus's CRL surpasses 7 mm, a heartbeat should be detected by transvaginal ultrasound ââ an ultrasound that is performed through the vagina and not on top of the abdomen like a standard ultrasound. If no heartbeat or cardiac activity is detected, then the pregnancy is likely a missed miscarriage. A missed, or silent, miscarriage typically occurs without the normal miscarriage symptoms.