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Pregnant, Ultra sound showed ill defined foetal pole and no cardiac activity. Had ovarian tumor. Suggest?

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I had an Ultra sound last week saturday and had the following analysis-
Gestational Sac- Irregular
Yolk Sac- Visible
Foetal Pole- Ill Defined.
Cardiac Activity- not visible
Everything else was normal. As per LMP, my gestational age was 6 week 4 days and as per ultra sound it was 5 week 4 days.
the measurements for the gestational sac were 77cm X 55cm.
I have the following questions-
1. Does this ultra sound look okay for my gestational age?
2.What does ill defined foetal pole mean?
3. Should I be worried about not having the foetal cardiac activity detected yet?

The dr has asked me to come for a follow up ultra sound in a week's time but i just can't help but worry about it.

As a previous history- I was operated for a borderline ovarian tumor in 2010 and my left ovary was removed.
I have had regular periods since then though and have been very regular.
Kindly help.
Posted Mon, 2 Sep 2013 in Pregnancy
Answered by Dr. Soumen Patra 3 hours later
Brief Answer:
Not worrisome, Repeat USG Scan After 1 Wk.

Detailed Answer:

Thanks for writing to us on XXXXXXX

It is not clear whether you underwent u/s scan where the probe was vaginal or on the abdomen. Followings are my comments regarding your queries:

1) Generally trans vaginal ultrasound scan reveals gestational sac at 4-5 week, yolk sac and fetal pole at 5-6 weeks and cardiac activity at 6-7 weeks. Trans abdominal ultrasound scan reveals all above parameters 1 to 2 weeks late.

Early ultrasound scan is not always conclusive to reveal all normal parameters of growing fetus. Here, you need to undergo trans vaginal ultrasound scan (TVS) after 7-10 days to check fetal cardiac activity & other well defined parameters.

Second thing, one week difference of gestational age in between original LMP (Last Menstrual Period) and ultrasound scan (USG) is considered as normal thing in early stage.

2) Ill defined fetal pole indicates that it was in developing stage at the time of ultrasound scan. Hope, it will be well defined in later weeks and visible in 2nd ultrasound scan. Nothing to worry here

3) Early ultrasound scan is not able to detect fetal cardiac activity. It is visible around 6-7 week on TVS scan and at 7-8 weeks on abdominal ultrasound scan. Therefore, you would not be worried at this stage and wait for next scan.

For healthy pregnancy, you would take healthy protein XXXXXXX diet (extra 350 kcal/ day than usual), drink plenty of fluids or water, take adequate bed rest, avoid heavy work/ long journey/ steeping uneven surface/ high heal shoe, maintain genital hygiene properly etc. In addition, you will take prescribed medication like folic acid, vitmain and progesterone supplements. Do periodic check up with scheduled USG scan to your doctor for better assessment of fetal well being.

Hope, this information is quite helpful to you. Let me know, if you need any further clarification.

Wish your good health & successful motherhood. .

Dr Soumen
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