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What Does My Ultrasound Report Indicate?

Posted on Fri, 11 Apr 2014

Question: hi doctor, I m 8 weeks and 4 days pregnant with fraternal twins and got my ultrasound scan done today and the scans are as follows: TWIN A GS IS 27.7 MM CRL IS 19.4 EMBRYONIC HEART RATE 180 YOLK SAC VISUALISED PLACENTA IS IMPLANTED ALONG POSTERIOR WALL TWIN B GS IS 26.1 CRL IS 19.4 EMBRYONIC HEART RATE IS 191 BPM YOLK SAC IS VISUALISED PLACENTA IS IMPLANTED ALONG THE ANTERIOR WALL MINIMUM SUBCHORIONIC BLEED NOTED ALONG THE INFERIOR ASPECT OF THE GESTATIONAL SAC ( APPROXIMATE VOLUME 1 CC) LENGTH OF CERVIX IS 3.4 CMS NOW I AM VERY WORRIED ABOUT THE MINIMUM SUBCHORIONIC BLEED ....IS IT SOMETHING TO WORRY ABOUT ALSO I HAVE NOT SPOTTED ANY BLEEDING TILL NOW? I AM TAKING 400 MG SUSTEN AND ASPIRIN ASA 50 MG

Answered by Dr. Aarti Abraham (13 minutes later)

Brief Answer: CONTINUE MEDICATION, REPEAT SCAN AFTER A WEEK. Detailed Answer: Hello Thanks for writing to us with your health concern. Can you please upload the exact ultrasound scan report for a better opinion ? From the information provided, there is minimal sub chorionic bleed in the sac of Twin B. The chorionic tissue supports the baby, in future, it forms the placenta. There has been some amount of bleeding in this tissue, this increases your chances of miscarrying the twin B. However, not all such sub chorionic bleeds will necessarily lead to an abortion. Sometimes, the blood gets absorbed, and bleeding stops, and the pregnancy grows normally. Only if the bleeding continues and increases is there a cause for concern. Right now, what you can do is - take rest. Avoid stress, intercourse and jerky travelling or standing for prolonged periods. Take the medications as prescribed - Susten ( progesterone ) for support to the embryo and aspirin to increase the blood flow to the baby. A repeat scan done after one week will tell you if the situation has improved. As you have not had any spotting or bleeding, it is a good sign Since the collection is sub chorionic ( behind the chorion ), the blood just gets collected and sometimes there is no visible vaginal bleeding / spotting. So please do not worry. Right now , just take rest, and think positive. Repeat the scan after a week. In case of bleeding / spotting / bad cramps - visit your doctor immediately. All the best PLease feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (21 minutes later)

Thanks a lot doctor does this effect my twin A also? what is the location of this bleed and what causes it ? and 1 cc is how much i mean big or small or very small? is transvaginal ultrasound safe during 1st 12 weeks?

Answered by Dr. Aarti Abraham (3 hours later)

Brief Answer: AS BELOW Detailed Answer: The location of the bleed is beneath the chorionic tissue which supports the baby - thus the bleed is between the uterine wall and this supporting tissue. 1 cc is a small amount, so do not worry. Only if it increases, it is a cause for concern. If , for some reason, the amount of bleeding increases, and twin B miscarries, then yes, there is a theoretical risk of miscarriage for twin A also. However, right now there is no point worrying because the subchorionic collection might get absorbed. Just take lots of rest. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (8 days later)

Hello Doctor, I went for my scan today i.e 10 weeks (pregnancy with fraternal twins) Unfortunately one of my twins heartbeat is no more and guess it has got miscarried. the other one is absolutely normal and also there is no bleed or fluid . I did not bleed at all and i am totally shocked to see no cardiac activity. Will this miscarriage effect my other twin. Also i did not take aspirin since last week as my doctor told me not to take. can this be the reason?

Answered by Dr. Aarti Abraham (1 hour later)

Brief Answer: DONT WORRY, OTHER TWIN WILL BE MOSTLY FINE. Detailed Answer: Hello again. My condolences on the loss of one twin. That said, it is good that the other is having good heartbeat, and there is no fluid or blood remaining. The dead twin and the tissues get absorbed within the body, it is called vanishing twin. It is much more common that you realize , happens in almost 50 % cases of twins. In most situations, as long as there is no blood / collection / pressure on the adjacent twin, it continues to grow normally and successfully. The doctor must have stopped aspirin as it is a blood thinner, and could potentially increase the bleeding, so that is not a reason, dont worry. Just concentrate on the remaining healthy baby, and wish you luck for your pregnancy. Do feel free to contact me anytime at - http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623 Continue taking the medications prescribed to you sincerely now. Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (4 minutes later)

my doctor prescribed me ASA or aspirin one day and an injection of CLEXANE 20 mg next day... what is this CLEXANE for? Hope taking this injection and aspirin will not increase chance of bleed again?

Answered by Dr. Aarti Abraham (12 hours later)

Brief Answer: TAKE CLEXANE AND ASA. Detailed Answer: Hello again. There is no bleed right now, the blood and the dead fetus has got resorbed. For the well being of the other baby, it is vital to take aspirin and Clexane. Clexane is also a blood thinner and improves circulation to the baby. Do not doubt the medications and take them as prescribed. Wish you luck.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar