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Dr. Andrew Rynne

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Pregnant. Started spotting after intercourse. Feeling tired with sore back. Any complication?

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Dr. Aarti Abraham

OBGYN

Practicing since :1998

Answered : 6011 Questions

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Posted on Tue, 8 Jan 2013 in Pregnancy
Question: Hi , i am pregnant around 4 to 5 weeks, i done the ultrasound and the hcg test about week ago, there was no heart beating yet, and i had sex with my boy friend, sense then i start to have a very dark brown spotting, is now 4 days , i am all so very tired and have a sore on the lower back, is not cramping but is there most of the time and just relive when i lye down on back.. i am very scared ...i don't have to get back to the doctor until after 15th of January, should i go early just for a check? is that any thing i should really be worried about? thanks
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Answered by Dr. Aarti Abraham 1 hour later
Hello XXXXXXX
I appreciate your query.
The B- HCG test is positive very early on in pregnancy.
As far as ultrasound is concerned, various milestones are seen at varying time intervals.
The gestational sac(GS) is the earliest sonographic finding in pregnancy. It will be slightly difficult to see if the mother has a retroverted uterus or fibroids.
In case of ectopic pregnancy, the GS is not seen inside the uterus.
The GS is identifiable until approximately 4 1/2 weeks only with a transvaginal scan.
The yolk sac appears during the 5th week. It is the second structure to appear after the GS. It should be round with an anechoic centre.
Failure to identify (with transvaginal ultrasound) a yolk sac when the gestational sac has grown to 12 mm is also usually indicative of a failed pregnancy.
A mass of fetal cells, separate from the yolk sac, first becomes apparent on transvaginal ultrasound just after the 6th week of gestation. This is called the fetal pole.
This is when the cardiac activity ( heart beat ) is seen too.
Absence of either ( fetal pole or heartbeat ) beyond 6 - 7 weeks of pregnancy is indicative of failed pregnancy too.
These parameters are seen on transvaginal ultrasound ( TVS ) only.
If you had an abdominal ultrasound, these details might not be seen easily in early pregnancy.
Also, if the ultrasound was done around 4 or 5 weeks, it is highly possible that the cardiac activity is not seen still, which is normal.
But the problematic symptom is having very dark brown spotting.
It could mean an impending ( threatened ) abortion ( miscarriage ), which is the commonest possibility.
If an intra uterine sac is seen ( pregnancy is inside the uterus ), you need not worry, as sometimes this kind of bleeding occurs with ectopic pregnancy ( pregnancy outside the uterus )
Sometimes, although rarely, such bleeding occurs with a totally normal ongoing viable pregnancy.
Only a repeat ultrasound will tell you the real diagnosis.
By now, you must have completed 6 weeks of gestation, so a sac with fetal pole and cardiac activity on TVS should be seen
With the kind of spotting described, you should not wait till 15th of January.
Please go for a repeat check up.
The soreness in the back , fatigue and tiredness are all part of the symptoms of early pregnancy.
Take enough rest, abstain from sexual activity till your doctor allows you and have plenty of fluids, a healthy diet and prenatal supplements as advised.
All the best and do post your further ultrasound reports etc. for further clarification.
You can contact me at
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Take care.
Above answer was peer-reviewed by : Dr. Aparna Kohli
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