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Pregnant. Advised Abortion After Seeing Ultrasound. What Are The Findings In A Report?
Question: Hi Sir
My Pregenency test has come positive on 8th January 2013 and I have went for scan on 9th January 2013 The scan report says: Gestational Sac 12.3mm corresponding to 5weeks 3 days with small fetal pole noted and Cervix is normal in size and shape and XXXXXXX OS is closed
and again I had a scan on 19th January 2013 the scan report says Sac is with 12.7mm corresponding to 5weeks 3 days with no well defined fetal pole noted with growth arrest.
My doctor advised me for abortion as there is an growth arrest.Request you to help me on the same.
My last period was : 8th Nov 2012 and I have checked my folical size on 17th november 2012 it was very small not upto the level I am thinking I might have been ovulated during december 1st week.
This is my first pregnancy and I am planning to wait for another week to deside on the abortion...request you suggestion on the same.
Thanks,
XXXXXXX
My Pregenency test has come positive on 8th January 2013 and I have went for scan on 9th January 2013 The scan report says: Gestational Sac 12.3mm corresponding to 5weeks 3 days with small fetal pole noted and Cervix is normal in size and shape and XXXXXXX OS is closed
and again I had a scan on 19th January 2013 the scan report says Sac is with 12.7mm corresponding to 5weeks 3 days with no well defined fetal pole noted with growth arrest.
My doctor advised me for abortion as there is an growth arrest.Request you to help me on the same.
My last period was : 8th Nov 2012 and I have checked my folical size on 17th november 2012 it was very small not upto the level I am thinking I might have been ovulated during december 1st week.
This is my first pregnancy and I am planning to wait for another week to deside on the abortion...request you suggestion on the same.
Thanks,
XXXXXXX
Hello XXXXXXX
Thank you for trusting us with your health query.
It would be of great help if you could post the details of your past few menstrual cycles - as in, the dates, duration and pattern of flow etc.
Also, if you have undergo follicular monitoring, then you should be knowing the exact date of ovulation - anyway if that is not the case, then by your ultrasound on 9th January ( 5 week 3 days ), it appears that you DID ovulate around the first week of December, as you guessed.
Going by the dating from your first ultrasound ( 9th january ), by now your pregnancy should be around 7 weeks.
A mean sac diameter of 20 mm or more without a visible yolk sac, or a size of 25 mm or more without a visible embryo, are major criteria for pregnancy failure with a 100% predictive value. One refrains from making the diagnosis of a failed pregnancy, till the gestational sac reaches a diameter of ATLEAST 18 mm, which is not the case with you.
But, In the first few weeks of pregnancy gestation sac growth is linear. A follow-up examination should show that the its volume doubles every week between the fifth
and eighth weeks. If it does not, this is suggestive of pregnancy failure. This has definitely happened in your case, as the gestational sac size is static , not growing, and the fetal pole has stopped being visualized.
In the absence of pain or bleeding or other ominous signs, you CAN wait for a week more, asking your obstetrician to prescribe appropriate support.
In the absence of interval growth after 7 days, the pregnancy does not have a good prognosis, however, it could be a late conception, due to late ovulation and there is a slight chance that the embryo could grow within a week more. If it does not, you should definitely go for a termination as advised. So, go for a repeat transvaginal scan after a week. Please ensure that all scans are transvaginal, not trans abdominal, as the sensitivity of vaginal scans is more.
One more method would be to go for a blood HCG test now, and then again after 7 days when you go for the repeat scan. If proper doubling and increase of B HCG is also not happening, it will confirm the diagnosis.
Take care, do not worry, and feel free to ask for further clarifications.
Thank you for trusting us with your health query.
It would be of great help if you could post the details of your past few menstrual cycles - as in, the dates, duration and pattern of flow etc.
Also, if you have undergo follicular monitoring, then you should be knowing the exact date of ovulation - anyway if that is not the case, then by your ultrasound on 9th January ( 5 week 3 days ), it appears that you DID ovulate around the first week of December, as you guessed.
Going by the dating from your first ultrasound ( 9th january ), by now your pregnancy should be around 7 weeks.
A mean sac diameter of 20 mm or more without a visible yolk sac, or a size of 25 mm or more without a visible embryo, are major criteria for pregnancy failure with a 100% predictive value. One refrains from making the diagnosis of a failed pregnancy, till the gestational sac reaches a diameter of ATLEAST 18 mm, which is not the case with you.
But, In the first few weeks of pregnancy gestation sac growth is linear. A follow-up examination should show that the its volume doubles every week between the fifth
and eighth weeks. If it does not, this is suggestive of pregnancy failure. This has definitely happened in your case, as the gestational sac size is static , not growing, and the fetal pole has stopped being visualized.
In the absence of pain or bleeding or other ominous signs, you CAN wait for a week more, asking your obstetrician to prescribe appropriate support.
In the absence of interval growth after 7 days, the pregnancy does not have a good prognosis, however, it could be a late conception, due to late ovulation and there is a slight chance that the embryo could grow within a week more. If it does not, you should definitely go for a termination as advised. So, go for a repeat transvaginal scan after a week. Please ensure that all scans are transvaginal, not trans abdominal, as the sensitivity of vaginal scans is more.
One more method would be to go for a blood HCG test now, and then again after 7 days when you go for the repeat scan. If proper doubling and increase of B HCG is also not happening, it will confirm the diagnosis.
Take care, do not worry, and feel free to ask for further clarifications.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
Thanks for your quick reply.
Is there any way that we can improve the baby growth and is there any health issues if I wait for 10 more days.
As of now I am not feeling any stamoch pain,vomtings nothing..I am feeling like as usual.
I am only worried that why from 9th XXXXXXX to till 19th XXXXXXX the days is showing as same like 5 weeks 3 days only and what is the problem for growth arrest.
If I could wait for few more days..is it going to be any problem for my health..Please advice.
Thanks for your quick reply.
Is there any way that we can improve the baby growth and is there any health issues if I wait for 10 more days.
As of now I am not feeling any stamoch pain,vomtings nothing..I am feeling like as usual.
I am only worried that why from 9th XXXXXXX to till 19th XXXXXXX the days is showing as same like 5 weeks 3 days only and what is the problem for growth arrest.
If I could wait for few more days..is it going to be any problem for my health..Please advice.
Hello
Thanks for writing back.
If this is a delayed conception, you can take folic acid and progesterone supplements to support the pregnancy.
However, in view of failed growth in 10 days, chances of this pregnancy being viable are very slim. But to err on the safer side, I would advise waiting for a week more.
There should be no XXXXXXX issues in waiting for a week more.
In case, you have pain/bleeding/cramping/fever or any abnormal signs, you should consult your doctor immediately.
The causes for a failed pregnancy are many, and can be investigated once this pregnancy is terminated.
You should send the products of conception for chromosomal analysis and biopsy, as genetic defect is the commonest cause.
Other causes could be hormonal defects, auto immune causes, diseases in the mother like thyroid, diabetes, renal disease etc. or infections causing fetal demise.
If the pregnancy is indeed pronounced to be non viable, and you go for termination, you should go for detailed testing and periconceptional counselling with a Genetic/ Fetal Medicine Specialist before planning your next pregnancy.
Take care
Thanks for writing back.
If this is a delayed conception, you can take folic acid and progesterone supplements to support the pregnancy.
However, in view of failed growth in 10 days, chances of this pregnancy being viable are very slim. But to err on the safer side, I would advise waiting for a week more.
There should be no XXXXXXX issues in waiting for a week more.
In case, you have pain/bleeding/cramping/fever or any abnormal signs, you should consult your doctor immediately.
The causes for a failed pregnancy are many, and can be investigated once this pregnancy is terminated.
You should send the products of conception for chromosomal analysis and biopsy, as genetic defect is the commonest cause.
Other causes could be hormonal defects, auto immune causes, diseases in the mother like thyroid, diabetes, renal disease etc. or infections causing fetal demise.
If the pregnancy is indeed pronounced to be non viable, and you go for termination, you should go for detailed testing and periconceptional counselling with a Genetic/ Fetal Medicine Specialist before planning your next pregnancy.
Take care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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