Background: Prompt diagnosis of early pregnancy failure is a difficult dilemma. There is no single test currently available which immediately differentiates continuing from non-continuing intrauterine or tubal pregnancy. First-trimester ultrasonography is routinely performed to confirm pregnancy location and assess viability. Objective: The aim of this study was early detection of spontaneous abortion risk. Material and methods: This study was conducted in the Department of Obstetrics and Gynecology, Zagzaig University. Sample size was 40 patients. Assuming that mean difference between Group (A) who miscarried and group (B) who continued pregnancy after 20th week in the mean gestational sac diameter 17.9 ± 3.3 and 20.7 ± 3 respectively. Results: 40 patients with mean age 27.55 ± 3.77 years old ranging from 21 to 37 years. All group were in 7th week of pregnancy. Parity was distributed as 25% were primigravida (PG) and about two third were 1-2 and only 10% had parity >2. MSD, CRL, MSD-CRL and FHR parameters were distributed as 19.98 ± 4.97, 8.42 ± 1.71, 11.56 ± 3.5 and 135.6 ± 15.13 respectively. Women in the abortion group had significantly lower MGSD, CRL, MGSD-CRL ratio and FHR values in comparison with women in the non-abortion group (12.9 ± 2.4 vs. 22.4 ± 2.9, 6.1 ± 0.91 vs. 9.2 ± 1.1, 6.8 ±1.6 vs. 13.1 ± 2.3 and 115.0 ± 8.2 vs. 142.0 ± 9.6 respectively) with p-value: < 0.001. Conclusion: Measuring serum progesterone, and first-trimester ultrasound measurements of MGSD, CRL, MGSD/CRL ratio and FHR were good predictors of early pregnancy failure and can be used as a risk assessment model that can predict the risk of early spontaneous abortion