Background: There is a high rate of spontaneous abortion in the first trimester of pregnancy, affecting an estimated 30-40% of all implantations. A low implantation location, a large or irregular yolk sac, a weak decidual reaction, and a sluggish embryonic heart rate are just few of the many sonographic indicators of predictors of poor result that have been identified by many authors. The aim of the current study is to investigate the predictive value of abnormal gestational sac morphology at 6-8 week for the pregnancy outcome. Patients and methods:The present study was a follow up observational study that included 188 patients aged 18-35 years, who presented at 6-8 weeks of gestation between May 2019 and February 2021 at Mansoura University Hospital's Antenatal Care Outpatient Clinic. Results: Larger gestational sac was associated with abnormal pregnancy outcome, like abortion (2.25±0.58 cm), preterm labor (2.33±0.0 cm), intrauterine feal death (IUFD) (2.70±0.28 cm), intrauterine growth retardation (IUGR) (2.93±0.93 cm) and abruptio placenta (3.45±2.19 cm). Also, larger yolk sac was also associated with abnormal pregnancy outcome, like preterm labor (5.0±0.0 cm), IUGR (5.57±1.07 cm), and IUFD (5.50±0.71 cm). Moreover, higher fetal HR was associated with abnormal pregnancy outcome, like preterm labor (155.0±0.0 bpm), IUFD (157.50±3.53 bpm), and IUGR (171.0±4.58 bpm). Conclusion: Statistically highly significant correlations were found between both yolk sac size and fetal heart rate, and abnormal pregnancy outcome, despite the fact that there was no link between gestational sac size and an increased risk of a negative pregnancy outcome.