Is missing a gestational sac during first ultrasound possible?
i am worried about how big the sac is, because I know that 44mm with no fetal pole will be a blighted ovum. But is it possible to miss such a large sac on the first u/s? Also, I'm concerned that the cyst is collapsed - will that contribute to miscarriage? Any help would be appreciated, because I cannot wait 2 more weeks for another scan wondering about this.
Blighted ovum likely
I have gone through your question and understand your concerns.
Gestation sac is visible only when the hCG levels are around 1500, therefore it may be possible that the gestation sac was not visible on the first ultrasound.
It is rare to calculate the gestation sac wrongly by a trained ultrasonologist.
If the fetal pole is not visible at this gestation sac size of 44 mm, then it is most probably the blighted ovum.
Collapsed cyst can be corpus luteal cyst, and it is not at all the cause of blighted ovum.
Chromosomal anomalies are usually the cause of blighted ovum, and these generally have no recurrence rate in subsequent pregnancies.
Hope you found the answer helpful.
Dr Deepti Verma
Maternal and fetal medicine specialist
Thanks for your answer. I totally understand what you are saying about the sac not being visible until about levels of 1500. I also understand if the sac is empty at 44mm, it is most likely a blighted ovum.
However, can a sac grow that fast - ie. Friday - not visible, then following Tuesday (4 days later) at 44mm? I thought that the sac grows approx 1mm/day?
Also, if my timing is right, the Tuesday ultrasound (where they say my sac is 44mm), I would only be 4 weeks, 6 days since LMP. Is that even possible to have a sac at a size of 44mm this early?
I think my confusion lies in how fast the sac apparently grew, and how much it grew in the timeframe that I believe I conceived. Could you shed some more light on that?
Thanks so much.
Please get a repeat ultrasound
You are correct in saying that the gestation sac do not grow more than1.5 mm a day.
Moreover, a sac size of 44mm is not possible at 5 weeks of gestation.
There has been some mistake in ultrasound reporting.
For confirmation, you can get a repeat ultrasound from a different centre, if possible.
Dr Deepti Verma
The User accepted the expert's answer
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