Had first ultrasound at 7 weeks 6 days. No cardiac activity and baby measured 6 weeks. Hcg level 46750. Is it possible to have a good outcome?

Consult your OB. Please consult your OB doctor. The HCG level is about right for 6-7 weeks. Us usually shows fetal cardiac activity at this time.
Needs reassessment! Too early to conclude something bad happened to baby. Need a repeat ultrasound and HCG to see if there is a change. I feel your pain and anxiety. Hang tight! best of luck!