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Understanding an Empty Gestational Sac: What It Means & Next Steps


Question
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Followup To
Question -
I am 26 and I have a 4 year old.  The first day of my last period was July 5th.  When I went to the doctor today they did an ultrasound and were able to see an empty gestational sac and said that the on the ultrasound appeared to be that of 6 weeks not 8.  I am having some testing done to see if my hormone levels are rising.  Is it possible that this pregnancy is still viable?
Answer -
If your last period started on July 5, you should be 8 weeks pregnant at this time. A sonogram only shows an empty gestational sac with no fetus or heartbeat until 6 weeks gestational age. At 6-7 weeks we usually see a fetus and hear a fetal heartbeat. If the sonogram showed no fetus at 8 weeks gestation, then either your date of your last menstrual period is incorrect, or the pregnancy may have stopped. I would suggest taking two blood tests for pregnancy (Beta HCG) 48 hours apart. If there is a halving of the results in 48 hours, you have had a miscarriage.If there is a doubling of the results in 48 hours, it indicates a viable pregnancy and you should repeat the sonogram in two weeks.

If I had miscarried shouldn't I have had cramping or bleeding?  I haven't even spotted.

Answer
A miscarriage is not always accompanied by cramps or bleeding. The pregnancy could merely have stopped growing and, if you do not see a fetus at 8 weeks from the first day of your last period, it is either a miscarriage or the date of your last period were incorrect.