<s>[INST] I got 5 weeks vaginal scan found sac but no heartbeat  through doc suggested sustain 200 through vaginal which way it will give good results by orally or vaginally my progesterone levels ar 26.2 at 4 w5d and at 5th w 0d 23.2 which it is decreases slightly. Previously 8 weeks miscarriage happened 1.5 yrs back d&c done. I am diabatic with irregular periods [/INST] Hallow Dear, You had previous miscarriage of 8 weeks. Hence, you have been prescribed Sustain 200 for being on the safer side. Sustain 200 is a progesterone preparation which helps to stabilize the pregnancy. In the scan, sac was found without heart activity. At 5 weeks, probably it is rather too early for cardiac activity to be noted. A repeat ultrasonography after one week may note the cardiac activity. If cardiac activity is noted, please continue Sustain to keep the pregnancy stabilized. However, if the cardiac activity is not noted even after one week and the margins of the sac are irregular, it is a pregnancy without baby in the gestational sac. This condition is known as Blighted ovum. Such pregnancy does not grow and needs termination of pregnancy if it does not get terminated naturally. So at this stage, continue with Sustain 200, repeat the scan after a week or more and then let the Obstetrician take further decision. I hope, this clarifies your doubts.   </s>