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Understanding Early Pregnancy: Spotting and Discharge - Dr. Rappaport


Question
Dr Rappaport,
 I'm actually the father, but have a question that I can't find answers for online and we left the doctor's office fairly abruptly last Friday.  My girlfriend and I are both 32 and her the first day of her last period was November 3.  
 She had some mild spotting beginning about one week prior to our appt and continuing for about 4 days and a small amount of some brownish discharge only once.  We spoke to the doctor by phone prior to the appt and were told that it wasn't abnormal and that around 30% of pregnant women have these symptoms and of them, most continue with a normal pregnancy.
 Well, we had the appt last Friday (Dec 16) and everything seemed fine until the ultrasound.  The technician completed the ultrasound and the doctor came into the room after viewing the pictures and told us basically that the gestational sack appeared abnormal.  It should show a smoother, more rounded surface than the more jagged edged sack that he saw and that this is not a good sign for a healthy pregnancy.  We are going back later this week for another ultrasound, but he said that chances were 50/50 and apologized for having to meet me under these circumstances.  That didn't give us a warm and fuzzy feeling and we've resigned ourselves to more than likely having to have a DNC at this next appt.  Thanks for any advice or information you can give.  Jason  

Answer
If your last period started on November 3, she would have been 6 weeks 1 days on December 16. Prior to 6 weeks gestation, a sonogram will only show an empty gestational sac, but no fetus. Hwever, by 6 weeks gestation, we usually see a fetus and a fetal heartbeat. It is not a good sign if you have not seen a fetus at this point. In addition, if there appears to be an abnormal appearing sac, it is worrisome. See what the next sonogram shows. Anything can happen.