Hi there, I appreciate your concern for your friend, but unfortunately an irregular gestational sac usually means that the pregnancy has failed. It is likely that for whatever reason, the foetus has failed to develop, and the sac is collapsing. We can usually see this on the ultrasound even if she hasn t started bleeding yet, which is why the doctor has asked her to prepare for a miscarriage. A miscarriage is not so unusual this early in the pregnancy, and most of the time we don t know the cause. It is quite possible that by random luck, the combination of genes for that foetus just wasn t viable, which is nature s way of choosing only the best to survive. I m sorry, but right now all that you can offer her will be emotional support. If this is her first miscarriage, I usually do not advise any additional investigations, and do not require her to do anything more than anyone else trying to conceive their first baby. The few major things that we usually advise for a healthy pregnancy would be folic acid supplementation, eating a good balanced diet, getting enough rest, no smoking, and no alcohol. If she is on any prescription medication, she needs to discuss with her doctor to see if there is a need to change it to something safer for pregnancy, even before she gets pregnant. Hope this helps, and all the best to you and your friend. Regards, Dr. Teh