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7 weeks pregnant. No fetal heartbeat detected. Is it possible to have a CRL of 9.8mm?

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Practicing since : 1999
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Is it possible to have a CRL of 9.8mm before 7 weeks of pregnancy with a Gestational Sac of 9.3mm? no fetal heartbeat detected. I have a 42 day cycle last period 20th August 2012.
Posted Sat, 1 Dec 2012 in Pregnancy
Answered by Dr. Timothy Raichle 39 minutes later
Hello, I would be happy to help you with your question.

Here are some facts to consider:
1. At a gestational sac size of 9.3mm, the estimated gestational age of the pregnancy is about 5 4/7 wks.
2. The crown-rump length of 9.8mm correlates with a gestational age of somewhere between 7-7.5 weeks.
3. Based on your LMP, you would be about 11-12 weeks right now.

Based on what you are telling me, I have concerns about the health of the pregnancy. A FHR is usually detected at about 6 weeks gestation. Based on when you conceived (even taking into account cycle length) you should be able to see a fetus with a heart beat given the data you presented. I hope that I am wrong, but this is looking like a miscarriage. One way to sort this out further if nothing happens on its own is to check serial hCG levels.

I hope this helps. Please ask if you have more questions.
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Follow-up: 7 weeks pregnant. No fetal heartbeat detected. Is it possible to have a CRL of 9.8mm? 39 minutes later
It is possible I conceived at the end of September? Would that not change things?
Answered by Dr. Timothy Raichle 26 minutes later
Knowledge of exactly when conception occurred is so variable that the ultrasound becomes a much more accurate way of looking at everything. Based on the crown rump length alone, there should be a heart beat visualized. This is assuming a vaginal ultrasound.
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Follow-up: 7 weeks pregnant. No fetal heartbeat detected. Is it possible to have a CRL of 9.8mm? 4 minutes later
Thank You btw :) I am having HGC's taken by Dr. Reason I am unsure is when we went for 12 week scan with our Son he was actually 6 weeks. I have looked at research papers and have seen it is possible that scans before 8 weeks may miss fetal heart flicker. We are having a second scan on Saturday private and have prepared for the worse but felt the NHS nurse sonographer and nurse we saw after the scan were highly unprofessional in that they handed us a sheet and then showed us the door! I had to google missed miscarriages because I had never heard of them :/ no explanation we didn't even see the baby on the scan it was so quick. Looking at 5th percentile of a 9mm CRL baby could be 6 weeks at which heart flicker occasionally may not be detected. We are preparing for a missed miscarriage but now 6 weeks after they said baby died I still have no symptoms. I'm hoping we can defy the norm and the mean measurements in some way regards Emma & thank you again
Answered by Dr. Timothy Raichle 4 minutes later
Yes, perhaps your main hope is that the person doing the scan was basically incompetent. You should never have been treated this way and you should let your doctor know this! I really hope everything turns out okay for you!!
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