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Conceived with IUI. Fetal pole measuring 5 week, sac measuring 6 weeks. Chances of miscarriage?

Mar 2016
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Practicing since : 2011
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I had my first ultrasound at 6 weeks (gestational) based on last menstral cycle. I conceived with IUI on the 5th of January or 12 days past my period. First HCG was 73 on 01/18/13, the second was 612 on 01/23/13 and third was 1,166 on 01/25/13. When I had the ultrasound on 02/04/13 the Reproductive Endocrinologist said I had an elongated sac, the fetal pole was measuring at 5 weeks 1 day and my sac was measuring 6 weeks. She did not see any problems with the sac except for the shape there does not appear to be any leaking. She informed me that I needed to prepare for a possible miscarriage - what are my chances of losing the baby? I have had cramping on an off since I became pregnant.
Posted Tue, 26 Feb 2013 in Pregnancy
Answered by Dr. S Patra 1 hour later

Thanks for writing to us. I have gone through your history & ultrasound report in detail.

As per your last ultrasound report, dated on 4th February, gestational age including appearance of gestational sac & fetal pole corresponds with the last menstrual period date (24th December) and there is no lagging or advanced growth of embryo. Also, beta HCG level on 25th January is quite good and indicates healthy pregnancy with corresponding gestational age. Therefore, both beta HCG value & ultrasound report are normal in this stage and nothing to worry at present.

I think that an elongated gestational sac in early weeks with above said normal parameter is not a health concern. Though, fetal cardiac activity & heart rate are to be measured.

Early ultrasound scan (USG) may not reveal fetal cardiac activity. For this, you need to repeat the USG scan after 2 weeks.

Another option, you can undergo one Trans Vaginal Sonography (TVS) to get early details on fetal pole, yolk sac and cardiac activity. These can be observed on 6 weeks of gestational age (from LMP) and approx 2 weeks earlier than plain USG scan.

If fetal cardiac activity and heart rate are within normal range, then there is no way to miscarriage or losing the baby. Slight abdominal cramp & low back pain are quite common & normal thing in pregnancy period. Always hope for the positive thing and keep up your spirit.

Here, you need to consult with gynecologist for proper guidance through medication & suggestive measures.

Do the following things for healthy pregnancy (specially in 1st trimester):

1) Take Healthy protein XXXXXXX diet with extra 350 Kcal/day than usual and eat more vegetables & fresh fruits.
2) Folic acid supplements & micronised progesterone tabs are required to support pregnancy & avoid miscarriage.
3) Drink lots of fluid/water to stay hydrated & for better feto-placental circulation.
4) Take an adequate bed rest and preferably 8-10 hrs daily in divided schedule.
5) Maintain personal hygiene including breast & genital care with proper washing.
6) Try to avoid stress/tension/emotional upset by regular XXXXXXX breathing (if possible).
7) Certain things should be avoided like any type of sexual activity/ intercourse, long journey/stepping uneven surface and high heel shoe (risk of fall on ground with miscarriage) etc.

Hope I have answered your query. If you have any further questions, I will be happy to help.

Wish you for good health and successful motherhood.

Dr Soumen.
Above answer was peer-reviewed by
Follow-up: Conceived with IUI. Fetal pole measuring 5 week, sac measuring 6 weeks. Chances of miscarriage? 24 minutes later
The ultrasound on the 5th was transvaginal - no heartbeat detected. RE said she was not as concerned with that as she was the elongated sac. Scheduled for another transvaginal ultrasound on 02/14/13. I am just very concerned about miscarriage.
Answered by Dr. S Patra 36 minutes later

Thanks for follow up query. I am happy to help you.

If you mention no fetal heartbeat on 6th week TVS scan on earlier query, I can give a better explanation for you. Though it seems just a mistake.

By the way, as your beta HCG level was quite good enough on 25th January, then you have slight chance to continue the pregnancy as sometimes early scan may not detect cardiac activity.

Therefore, you have to undergo for repeat TVS scan as per schedule along with estimation of beta HCG level to rule out survival of the pregnancy. If repeat scan is unable to detect fetal cardiac activity or there is low level of beta HCG, then you should have to lose the pregnancy or proceed to miscarriage.

Here, folic acid supplements & micronised progesterone are essential to support pregnancy & avoid miscarriage. So please consult with your doctor to continue this.

If you do not have any clarifications, you can close the discussion and rate the answer.

Be well & stay healthy.

Dr Soumen
Above answer was peer-reviewed by
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