Pregnancy questions about not having a gestational sac

Patient: Helloi have been to the doctor i am 9 weeks and they told me there is a baby but no sac what does that mean

Symptoms: Spotting then bleeding and also cramping and blood clots with tissue but that only happened once

Doctor: Hi,Thanks for the query.I understand your concern.Baby without gestational sac at 9 weeks of gestation possibly indicate miscarriage.Your history of bleeding supporting this.According to your history the possibilities are inevitable abortion or missed abortion or rarely abdominal pregnancy.Inevitable abortion means pregnancy cannot be continued further.Missed abortion means sometimes after passing few products of conception other non viable products will remain inside the uterus.Abdominal pregnancy is very rare, in which case baby can be seen outside the uterus without gestational sac.In any of these conditions if the baby is not having proper gestational sac and if the heart beat is absent, pregnancy cannot be continued usually.Please discuss these things with your doctor and plan further management according to her advice.Take care.