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Early Pregnancy Ultrasound: Understanding Embryo Development & Bleeding


Question
Hi Kristy -
I had my ultrasound and it showed a 5.9mm embryo with a beating heart! It was beating at around 110 bpm which I thought was low but my doctor assured me is perfectly normal for an embryo that size. He also saw the source of the bleeding, a small smudge near the cervix. We don't really know what that is.

I am still spotting and am passing large amounts of thick mucus. Almost like a small mucus plug. My cervix feels closed though. So I gues sonly time can tell at this point.

Thank you so much for assuring me that everything was fine. I just can't believe i actually have a normal baby in there, and that my chances of a normal pregnancy are good! Thank you so much!
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The text above is a follow-up to ...

-----Question-----
I will try to make this brief. I am pregnant for the 12th time. I have 2 daughters. I have had 8 miscarraiges and one molar pregnancy. I am 6w2d pregnant. (So far we do not know why I keep losing babies, I have had a full abttery of tests.)

My hcg levels are as follows:
13 dpo - 61
17 dpo - 596
24 dpo - 16,730
My progesterone is 21.8 without supplements, however I have started taking 200 mg of prometrium morning and night.

I had spotting at 5w3d so I had an early ultrasound that showed a sac and yolk sac.

My doctor said that I should see a heartbeat when the level reaches 6000 or greater.

I am worried that we did not see a heartbeat with a level of almost 17,000. And I am also worried that my hcg levels seem so high. The ultrasound showed no recurrence of the molar pregnancy but I can't help but worry.

Do these numbers and u/s findings sound normal? I am going out of my mind with worry. I can barely get myself through to the ultrasound next Tuesday.

-----Answer-----
Hi Rose :)

I am so sorry to hear of your anguish, but I certainly do understand your worry, given your history.

But your levels are absolutely GREAT! And this completely indicates that your pregnancy is one that is healthy, and thriving.

I am happy that you are indeed on progesterone suppliments. Although your levels are great, kudos to your doctor for taking precautions. The Prometrium, is simply given to you as a precautionary measure given your history. So your doctor is just making sure that area is covered, which is very efficiant.

Keep in mind that spotting anytime during the first trimester, is common. But I understand given your history why it would completely terrify you. But you had an ultrasound, that indicated everything is just fine, so this is fantastic news :)

Do not worry that your HCG levels are high. Let me tell you, when they do not double, or if they fall then you have reason for concern.

Also, I dont want you to be alarmed right now about not seeing the heart beat. All to often, heartbeats are not seen until atleast 4-6 weeks into gestation. Again, it depends on the patient. But you are just a little over 6 weeks pregnant at this point, so there is absolutely no reason for alarm. Infact, I wouldnt be in the least surprised, you are able to see the heartbeat on Tuesday. So please, dont panic at this point.

Your numbers are great, and at this point, I see absolutely no reason for any concern. Your levels are great, and your ultrasounds to this point have ruled out any chemical, molar, or blighted pregnancies, so this is all great news for you.

My only suggestion, is to keep yourself calm. (I know its difficult). But just no that your worry, does have an impact on your condition, so keep that in mind. And for the next 6 weeks or so ..take it really easy. No heavy lifting,no strenuous excerise, and try if possible to keep sex to a mininum. Let hubby do the brunt of the housework,and errands. Its important for you to right now stay off your feet when you can, and keep those feet elevated.

Rose, So far, you seem to be just fine. Will you write back and let me know how your ultrasound goes on Tuesday? I would be very intrested in knowing...

Thanks for writing, and I hope this has put your mind at ease. If you have any more concerns, please dont hesitate to write back :)

-Kristy

Answer
Hi Rose!

Aww I am thrilled for you! Just as predicted, everything is just fine, and you were indeed able to see that little ones heart beat. What GREAT news!!

That little smudge over your cervix, could possibly be a small hematoma. No worries though, it sounds very small, and shouldnt be an issue. A Hematoma is a blood clot, that sometimes develop because of a ruptured vessle in the placenta. I am in  no way saying that is the issue, but it does sound like it could be a possibility, and could be why you are spotting. Regardless, of whatever it is, your doctor doesnt sound to concerned, and the main thing is that little one is healhty and thriving.

Congradulations, to you ..on your healthy pregnancy! I am thrilled to bits!

All the best :)

-Kristy