QuestionI am a 35 year old woman, never pregnant. On Nov. 23, I began my period. I began what I thought was another cycle on Dec. 21. As it turns out I am pregnant (verified by both Home pregnancy test and quantitative blood test HcG level 294.6 on 12/29). My doctors estimated me at 6 weeks, but ordered an ultrasound since the Dec. 21 "period" was regarded as spotting. Have normal pregnancy symptoms, morning sickness, fatigue and tender breasts.
Took the u/s on 1/5/05--the embryo is only 4 weeks and 6 days! They detected a yolk sac, but not an embryo. I was told to do another u/s in 10 days. I am concerned because I was on the pill for 15 years for treatment of endometrosis. I came off the pill July 26th. My periods were very irregular until November (and I thought) December which would have been 29 days each. Is my estimated gestational age off or did the baby stop growing? From what I have read, my situation is consistent with both a miscalculated ovulation or LMP and a missed abortion. Am I missing something? The next ten days are going to be very difficult.
AnswerWe have to assume that your last period started on November 23. If so, you would have ovulated around December 6 and could have conceived if you had unprotected sex on November 5,6,7,, or 8. If you did become pregnant on one of those days, on January 5, a sonogram should have shown a 6 weeks size fetus with a fetal heartbeat. If the sonogram only showed a 4 week 6 day gestational sac but no fetus or heartbeat, either your dates are incorrect and you conceived between December 11-14, and your last period started on November 29, not November 23. Normally, on a sonogram, we only see an empty gestational sac until 5.5 weeks gestational age and do not see a fetus until 6 weeks gestation. I would wait 14 days rather than 10 days to take the next sonogram. If, by then, there has not been any change and there still is a 4 weei 6 day gestational sac with no fetus, then the diagnosis is "missed abortion". However, there is always a chance that your dates were incorrect.The HCG level is very low and is not promising. It certainly sounds like a "blighted ovum" or "missed Ab", but do not lose hope yet.
