QuestionHello, my 17 year old son and his 17 year old GF Kim are expecting a baby, last week on 01/14 they went to the doctor and had a vaginal ultrasound and prenatal visit, they said they measured the baby and it measured at 8 weeks 1 day, however they said they could not hear the heartbeat, they took an HCG blood test and rescheduled a visit for yesterday 01/21, Yesterday they went back to the doctor, they were first told her HCG levels were 65K, but when the did the vaginal and the tummy ultrasound they still say they could not find a heartbeat, HOWEVER, this time they said the fetus was measuring at 7 weeks 4 days, (compared to the week before it should have been 9 weeks)
They told my son and his GF that the baby had not survived and gave her a prescription for a pill to take to eliminate the fetus, or they told her she could just wait for it to take place naturally. They did not however schedule any follow-up appointment which surprised me when he told me.
They have decided not to take the pill, but do not know what to do. I did tell them that IF for some reason the first test that showed she was 8 weeks was incorrect and she is actually only 7 weeks then it is possible that would be the reason they could not hear the heartbeat since everything i have read said it may not be heard until around 9 weeks.
My question i guess is should they have made a followup with her? i mean if she took the pill or not it would seem they would want to follow up and make sure that everything had left her body with no infections. Also, could there be mistakes with the measurements or if the fetus is no longer viable would the size difference make since?
Thank you for any direction you can lead us
Lin Carl
AnswerDear Lin,
The gestational sac can typically be visualized as early as 4.5 weeks of gestation and the yolk sac at about 5 weeks. The embryo can usually be observed and measured by about 5.5 weeks. A visible heartbeat can often be seen and detected by ultrasound at about 6 weeks and is usually clearly detectable by 7 weeks. In general, ultrasonography dating of a pregnancy is more accurate than dating using the date of the mother's last menstrual period. The biometric crown-rump measurement (CRL) of the six to 12-week fetus provides the most accurate measurement -within three days of true gestational age. Also, with an hCG level that high, it would indicate that the fetus should be at least 7 weeks along in the pregnancy.
If they have chosen to wait and see what happens naturally, that is perfectly ok and many women do just that. However, it would be beneficial for all to try to stay realistic about the potential outcome. Doctors do not like to share this kind of news and certainly do not dismiss a pregnancy as lost without due cause, which is why the follow-up ultrasound was scheduled for one week later after the initial one did not find heart activity. And certainly, if your son's girlfriend does miscarry, I would suggest returning to her doctor after all the bleeding has ended to make sure that her uterus has emptied. However, many do not schedule a routine follow-up unless there is a problem with continued bleeding past a normal amount of time and/or a delayed first period after the miscarriage.
I hope this has helped you and answered your question. I wish you and them well.
Brenda
