Understanding Fetal Pole Without Heartbeat: What It Means

Question
Hi! I am in a very confused state of mind and am hoping that you can help.

My LMP was 28rd May. I have a regular 27 day cycle, but the previous cycle before this came at 24 days. I tested for pregnancy on 23rd June and got a very faint positive. I tested again the next day and got a negative. A week later, I got a strong positive.

I went for my first u/s when I was six weeks - but the doctor said it looked more like five weeks. She saw a sac, but nothing else. She sent me back for two weeks.

Yesterday I had my second ultrasound. She saw a clearly formed sac, yolk sac and a fetal pole measuring around 3.4 mm. However, she could not detect a fetal heartbeat. She has told me that the chances of this being a viable pregnancy are very low - yet we should wait for a week and do another ultrasound.
I;m devastated - this will be my second loss, if we don't detect a fetal heartbeat on Monday.
I do have a retroverted uterus - could that have anything to do with her not being able to detect the heartbeat?
Do I have any hope?

Answer
Dear Sandhya,

Although by 6 weeks gestation we expect to see some fetal heart activity, another landmark that we tend to go by is embryonic measurement. Embryonic cardiac activity should always be seen when an embryo measures greater than 5 mm. Since yours was at 3.4 mm, there may be a slight discrepancy in dating or just a slight delay in development.

Here's the thing - you can't change this one way or the other by worrying. If there is a problem with the fetus it is most likely a chromosomal abnormality and if that is the case, your body will recognize it and nature will handle it in the way the nature does. On the other hand, there is no reason to give up hope until you have concrete facts. Your doctor just wanted you to be aware that there may be a problem so you weren't blind-sided if something happened in another week or so. Just prepare yourself either way. As much as I know you want it to be, it just is not in your hands or control at this point. All you can do is just wait and see what progress there might be with the next ultrasound.

I hope this has helped you and answered your question. I wish you well and will have a good thought for you.

Brenda