No Fetal Heartbeat at 10 Weeks: What to Do?

Question
i had a vaginal ultrasound today that showd no heart beat. I am exactly 10 weeks 0 days according to the measurements. my doctor sent me over to have another ultra sound the same day,this was just one on top of the belly there was no heart beat again.No fetal movement was showing.  I have had no bleeding spotting or other issues. she wanted to scheduel a d&c right away and i said no,we are suppose to do another ultra sound in 4 days. Is this long enough? and is it normal to not hear the heart beat at 10 weeks?

Answer
Dear Andrea,

A visible heartbeat can often be seen and detected by ultrasound at about 6 weeks and is usually clearly detectable by 7 weeks - especially via trans-vaginal ultrasound. Unfortunately, 10 weeks is quite far along in measurement of the fetus to not have any visible heart activity.

I don't blame you a bit for requesting a follow-up ultrasound next week. However, you really must try to prepare yourself for the possibility that there will again be no heart activity seen. I would also want to verify that hCG are not rising appropriately. In a normal healthy pregnancy, we expect hCG levels to double every 48-72 hours. I would encourage you to take along your husband or significant other for support to that next visit.

If the pregnancy was only recently lost, your body may not have begun the process of miscarrying yet - thus, there would not necessarily be any bleeding or uterine cramping yet.

Please know that most miscarriages are not preventable and the cause cannot be specifically determined. Almost all are thought to be due to a chromosomal abnormality - meaning that something is not correct with the baby's chromosomes. Most chromosomal abnormalities are the cause of a faulty egg or sperm cell, or are due to a problem at the time that the fertilized egg went through the division process. I know that this was the last thing you expected when you went for that office visit and you are probably half-numb. I also know nothing I have said can possibly help that. But I do hope that I have answered your question with as much compassion as possible under these circumstances. I do not ever want to kill hope in any way, but I try to answer as honestly as possible. I will have a good thought for you.

Brenda