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Early Pregnancy Concerns: Missed Heartbeat at 5 Weeks 3 Days - Seeking Advice


Question
I will give you the info first and then ask my questions:

have 2 children never had miscarriage
age:  37
LMP:  December 8, 2004
normally 28-day cycle
Only chance of conception:  December 30, 2004

not having spotting/cramping
pregnancy symptoms come and go (nausea, bad taste in mouth, excessive salivation)

went for dr appt on Feb 7 (regular first appt - no complications) dr did sonogram did not like what he saw sent me for another sonogram Feb 8

Feb 8 results and blood test results:

Fetal size - just about 5mm
Fetal age:  5 weeks 3 days
HCG level:  36,000

Doctor did not do followup blood work.  Scheduled me for a D&C for Friday, February 11.  I am going for another sonogram before the D&C.  Is it possible a sonogram might miss detecting the heartbeat or it might not appear for another couple days?  

Answer
If your last period started on December 8, then you should now be 9 weeks pregnant. By now, a sonogram should have shown a fetus and a fetal heartbeat. However, if the sonogram only showed a 5 week 3 day fetus, it may be that you became pregnant later than usual. Prior to 6 weeks gestation, a sonogram will only show an empty gestational sac but no fetus or fetal heartbeat. This is a normal finding at 5-6 weeks. I would suggest having another sonogram before you have a D&C. Take the sonogram at least one week after the last sonogram. If there still is no growth of the fetus, then a D&C is indicated.