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Is the level of erythrocyte sedimentation rate at 29mm/hr normal for 7-week pregnancy?

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hi! is the level of erythrocyte sedimentation rate at 29mm/hr normal for a 7-week pregnancy? will it result in complications in pregnancy later on? my haemoglobin level is 11.7 g/dl, hematokrit is 36% and Fibrinogen is 363 mg/dl. The result of all other indicators is normal.....
Also I had USG today and even after almost 8 week pregnancy, the baby looks very small and cannot make out anything...The doctor has now advised to take Lovenox 60Mg-0.6 ml injection every day and will take blood test again on 20th october and will see the usg again to know about the baby this treatment fine? is the above normal? the doctor says it is sometimes normal and with this daily injection, things will get better and baby may grow properly..Can you give me any more details about the ultrasound?
Size in mm?From the ultrasound picture, it is written +GS - 1.93 cm
G.A. 7w 0d
EDD : 25.05.2013
fetal heart rate not given
as informed earlier, the baby looks very miniscule, hardly can make out....that is why doctor suggested to take the daily injection till 20.10.2012 and will check again. The injection prescribed is Lovenox from Sanofi Aventis.
To be taken on 7th oct at 4 pm here in jakarta, taken on 8th oct at 6 pm and from 9th oct onwards to be taken at 8 pm everyday till 20.10.12.
Hope above information is sufficient?
Fetal heart rate?.kindly advice.
Posted Wed, 24 Oct 2012 in Women's Health
Answered by Dr. Timothy Raichle 9 hours later

In terms of expecting to be 8 weeks along, and having an ultrasound that shows the fetus to be only 7 weeks along is not so unusual. Even with regular cycles, there is some variation in terms of when conception occurs, and when implantation occurs. This could easily lead to a discrepancy of one week in terms of what they see on ultrtasound and how far along you think you should be. The important thing is how the baby ends up growing over time - so it will be very telling what the next scan (usually done in one week) shows, and you will likely need to adjust your due date based on the scan and NOT based on your last menstrual period.

In terms of the use of Lovenox, I will say this: In the United States, it is not used unless there is an indication that might include:

1. A history of multiple prior miscarriages
2. A history of blood clots
3. A predisposition to forming blod clots
4. A history of a prior pregnancy complicated by preeclampsia, fetal growth restriction, or still birth (with an underlying explanation in any case)

So, just because the baby appears to be growing small is not really an indication to use Lovenox - you might want a second opinion on this recommendation.

Finally, at 7 weeks, the fetus is measurable, but looks like an oval ball with an ill-defined edge - this is also normal from what you describe.

I hope that my feedback is helpful - if you have more questions, you must ask!! - DR XXXXXXX

Above answer was peer-reviewed by
Follow-up: Is the level of erythrocyte sedimentation rate at 29mm/hr normal for 7-week pregnancy? 1 hour later
Thanks for your reply. I will provide my history so that you can analyse again and give a more informed answer. I have had 3-4 miscarriages. Also got removed cyst in uterus. 1st miscarriage in 2007 was prematurely born, did not develop proper hands and feet and was aborted and delivered normally as still born, was a boy. All other miscarriages were after few weeks itself. Last time got pregnant via ivf procedure in august 2011, but the baby did not develop heart beat even after 8 weeks so had to abort the baby. Now pregnant again 7-8 weeks. Doctor advised to take blood test that showed erythrocyte sedimentation rate of 29 mm/hr, haemoglobin rate of 11.7 g/dl and Hematokrit rate of 36. Also Fibrinogen at 363 mg/dl. The doctor said the blood is thicker than normal, hence advised to take Lovenox injection.
Please let me know if above is normal and whether there is a chance of normal pregnancy here. I also feel that the next scan will give the correct picture. Please give your comments and advise based on the additional information provided. I am 41 and my husband is 40 years old. Thanks.
Answered by Dr. Timothy Raichle 25 hours later

You are a 41 year old who has had 5 pregnancies (including the current one) and 4 miscarriages. It sounds like one of the losses was a little different from the others in that you made it further but there was abnormal / unhealthy development of the boy. So, I will assume 3 unexplained first trimester losses. And I am very sorry about these losses.

First, I would like to address the labs. We normally don't check a sedimentation rate during pregnancy, and in fact it is an indirect measure of fibrinogen levels. Fibrinogen is always elevated during pregnancy. The hemoglobin and hematocrit levels are also normal for pregnancy. So the labs that you have listed including their results are completely normal. To say that your blood is "thick" during pregnancy is a true statement for almost any pregnancy woman, as pregnancy is a state of increased clot risk. In some women (perhaps yourself) this clotting risk might be increased for unexplained reasons and lead to recurrent losses.

Typically, in women with a history of 3 or more unexplained first trimester losses, a workup is initiated that includes:
1. An ultrasound of the uterus when you are not pregnant
2. Labs to check for a predisposition to clotting
3. A check of you and your husband for any genetic predisposition to miscarriage (usually done as a check of your karyotypes or chromosome quality and number)

You might have had more labs done than you are aware, and certainly in the case where NOTHING comes back abnormal, it would not be unreasonable to place a woman with your history on Lovenox. The only thing that I will add about this is that the usual "prophylactic" dose of Lovenox is 40mg once daily. If you have already done the 60mg it is likely of no harm, but I would check with your doctor on this dosing.

I hope this helps you further. Again, I am sorry about the delay. If you have more questions for me, please ask!

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