QuestionI am 6 wks pregnant exactly (know from IVF date); saw gestational sac, small yolk sac, and small fetal pole but no heartbeat yet with vaginal ultrasound. Is this normal? Also I've had 2 episodes of spotting red blood in last week, lasting only a few hours, then turning brown, both times a day after having an orgasm. Ultrasound showed some bleeding behind pregnancy. What does this mean and is it definately a bad thing?
AnswerDear Jennifer,
Vaginal bleeding can occur frequently in the 1st trimester of pregnancy and may not be a sign of problems. Unless you begin to experience cramping (like strong menstrual cramps) and/or clots or tissue passing with heavier bleeding, I would not be overly concerned. However, it is worth noting to your OB doctor at your next visit.
It sounds like your spotting might be related to a small subchorionic hematoma. A subchorionic hematoma is simply a collection of blood either within the folds of the developing placenta or between the placenta and the uterine wall. A small to moderate sized hematoma will usually dissipate on its own and not have any negative effect on the pregnancy. At times it can cause some vaginal bleeding/spotting. Large hematomas that hemorrhage can carry a higher risk to the pregnancy. Thus, the smaller the hematoma the better.
It sounds as if yours is fairly small in size (from the verbage used). If so, the blood should be reabsorbed and it will resolve itself. During the next ultrasound, they will look at it again and re-measure to make sure that it is the same size or smaller. As long as there is appropriate fetal growth and a strong, steady heart rate, you should have no serious concerns regarding this hematoma.
Please be aware that you should never wear a tampon or introduce anything else into the vaginal area such as douche or sexual intercourse if you are currently experiencing bleeding. It is also useful to wear a pad or pantiliner so that you can accurately judge the amount of spotting/bleeding.
As to the ultrasound findings, 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.
I hope this has helped you and answered your questions. I wish you well and a Merry Christmas.
Brenda
