49 days pregnant without fetal heart with bleeding generally refers to the ultrasound did not see the fetal heart, fetal buds, vaginal bleeding, may be the time of late implantation, may also be the embryonic arrest. 49 days pregnant ultrasound no fetal heart, fetal buds and bleeding, may be late in the time of implantation, it is generally recommended to observe for another week, and then recheck. In addition, it is recommended to check blood progesterone and HCG to check whether blood progesterone and chorionic villi are consistent with color Doppler ultrasound. If the progesterone level is low, it is abnormal and can easily lead to bleeding and miscarriage. The color ultrasound will be repeated one week later to find out the fetal heart, buds and the size of the gestational sac. If there is a fetal heart and buds, the pregnancy should continue with close monitoring. If there is still no fetal heart and buds, it is recommended to consult a medical professional to decide whether to give up and terminate the pregnancy promptly in the hospital.