QuestionQUESTION: dear sara,
I just got my first ultrasound today ie nov 24. My LMP was 30 sep 2010. This is my first pregnancy. Dr did US and i got below information. It was abdominal US. Gestational age : 7 week n 6 days.
G sac 3 cm_ 7 week +5 days.
Crl :0.9 cm_7 weeks
Cardiac flicker not seen at time of scan.
I ve no spotting. No cramps as such. What could be reason of missing heart beat? Dr advised me re ultasound after 1 week. Im very worrried n tensed. Pls reply me asap.
Thanks
ANSWER: Hello,
I am so sorry you are going through this.
Now the fact that this was only a transabdomninal scan could be that it was just not seen by the naked eye. The sound waves have to travel through layers of subcutaneous fat and muscle before reaching the inside of the uterus. It can make an early pregnancy harder to visualize. Typically, a CRL measurement of the baby of 5 mm or more should show a heart beat. Your measurement was 9 mm so this is a bit concerning for me, but again, it could be that it was not visualized.
In the practice I work for, if there is no heartbeat seen by the transabdominal images, then we move on to do the transvaginal ultrasound because this allows us to get more closer to the baby and the resolution and clarity of the images is much better. A transvaginal ultrasound is when we use a slender transducer that is gently inserted into the vagina a couple of inches. I am actually surprised that they did not do that.
The CRL of your baby came to 7 weeks so this could possibly be just too early to find it. Between 6 to 7 weeks can vary with each pregnancy as to when we see a heartbeat. But in one more week we should definitely be able to see a flicker, whether transabdominal or transvaginal. I can only imagine how hard it is to have to wait but in one more week you will have alot more information.
Some women, even when there really is no heartbeat, will not have any pain or bleeding for awhile. It depends on the woman's body when the miscarraige will happen; could be days to even weeks. I would have a cautious outlook but try to stay positive. If this does not work out, please be aware that it is nothing you did or did not do. I have seen this outcome go both ways. My thoughts are with you.
Sincerely,
Sara
---------- FOLLOW-UP ----------
QUESTION: Hi sara,
Thankyou so much for your reply. The dr said since its my first pregnancy so she do not advise for transviginal US. Its very hard and difficult for me.I want my child to live but its all in God's hand. I ve to wait for a week atleast. My husband asked me not to go for anymore US as he is just too upset. But we need to get US next week.
My weight has increased. i weigh around 65 Kg and im 5"3 in height. Dr. also said may be im bulky that can be a cause too that heart beat is not detectable. Im not sure if she just wanted me to stay positive.
Sara, does it happens that beat comes in 8th or later weeks normally?
How early should an US be done?
also does the fetus grow in size without heartbeat? what incase if next week size is increased only.
If woman does not go for D&C and natuarally she does not get miscarried then what happens? does a lifeless fetal grows inside.
Remember in prayers.Need them a lot.
Thanks
Aira
AnswerHi Aira,
To answer your questions, as long as a patient has no problems with the pregnancy and not considered high risk, some woman do not get an ultrasound until their 18-20 th week. Some get it early in the first trimester for dating purposes. Some doctors will do a routine first trimester ultrasound, it really just depends on who your doctor is. The bad part about getting a very early ultrasound is sometimes we can't see everything even though it could be progressing normally. At 5 weeks we will only see the gestational sac. At 5.5 to 6 weeks we will see the yolk sac in there. At 6-7 weeks we should see the fetal pole next to the yolk sac, and may or may not see a flickering heartbeat. At the 8 week mark, we should definitely see a heartbeat.
Without the beating heart, the baby will not grow past the point it got to, and may even shrink a little as time goes by. Your body will miscarry, but for some women this can take awhile to happen, so there are options if they were to choose not to wait.
I am praying it was just not visible, but you do need to go and get this next ultrasound because you will find out what is going on. Pay attention to your body and if you have bleeding or bad cramps call your doctor. Try to stay positive and I am definitely thinking of you.
Sincerely,
Sara
