Objective    : To assess the correlation between fetal heart rate and the fate of pregnancy in women with first trimester bleeding. Methods     : This prospective observational study included 281 consecutive women with first trimester bleeding and Singleton pregnancies. The embryonic heart rate measured at the time of first trans-vaginal scan as per protocol in our university hospital for the evaluation of pregnancy. The heart rate was classified as slow if it was fewer than 110 beats per minute. The primary outcome measure is the occurrence of spontaneous early pregnancy loss prior to 12 weeks. Other outcome measures included the occurrence of late pregnancy loss (prior to 24 weeks), gestational age at birth, and fetal weight at birth. Results      :  Embryonic heart rate at less than 110 bpm was associated with a high likelihood of pregnancy loss. The sensitivity, specificity, positive and negative predictive value, and accuracy were 43.1%, 86%, 40.7%, 87.2%, and 78.2%, respectively.  The OR (95% CI) of first-trimester pregnancy.  Conclusion:   embryonic heart rate can be an independent predictor of the outcome of pregnancy in women with intrauterine pregnancy complaining of first trimester bleeding.