What does the pregnancy ultrasound report indicate?

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Posted on Tue, 9 Jun 2015 in Pregnancy
Question: My wife is pregnant. We did pregnancy home test on 9th May and it came +ve. on 19th May we had a scan with doctor and one more with radiologist and they are saying no heart beats are seen so this might be a case of miscarriage. Doc said we will do final test on 23rd. My wife's last period start date was 3rd April.
Below is the report content from radiologist:
Single intrauterine gestational sac
MSD: 1.7cms 6weeks 3 days
Yolk sac seen
Fetal node not visualized yet.
Both ovaries are normal in size.
No adnexal mass
No free fluid in pelvis
********************************************************************
This scan was not transvaginal. Since my wife is not willing for transvaginal.
She had 1 miscarriage earlier. D&C happened on 3rd Feb 2015. Doc said if we dont see heart beats by 23rd we need to take action so that we dont need to go for D&C again.
So what is your opinion? Can we wait after 23rd may if no heart beats seen on that day. How many days we can wait before going for D&C. Please give your suggestion
doctor
Answered by Dr. Sameer Kumar 16 minutes later
Brief Answer:
anembryonic gestation

Detailed Answer:
Hello,
Thanks for the query to healthcare magic.com for an opinion,

Considering her LMP to be 3 April, as of 19th may, your wife would be 6 weeks and 4 days pregnant. The ultrasound suggests a med or mean sac diameter of 6 weeks + 3 days, thats fine but there is no foetal pole yet which should have been visible by 5-6 weeks of gestation.

In absence of foetal pole at present even at 6 weeks + 4 days, the next step is to look for HCG levels with serial beta hcg monitoring on alternate days. If the levels show a rise of more than 65% then that indicates a developing pregnancy and there may be a chance of expecting a foetal pole in another week but if the levels are decreasing and in absence of foetal pole in the gestational sac, this would be a chemical pregnancy or an embryonic gestation without foetus inside the sac.

It is after that the decision to terminate pregnancy by medical methods should be taken which is safer till 49 days of pregnancy or 7 weeks. Post 49 days to 63 days D& C may be a possibility if natural abortion doesn't occur.

So it is wise to get a serial beta hcg test done hence and a repeat Ultrasound preferably transvaginal at 7 weeks now.
I hope i have answered your query in detail,
Wishing you good health,
Regards
Above answer was peer-reviewed by : Dr. Pradeep Vitta
doctor
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Follow up: Dr. Sameer Kumar 16 minutes later
Doctore, Thank you very much for the reply. Can you please tell us what is
"this would be a chemical pregnancy or an embryonic gestation without foetus inside the sac. " in layman's language? Becuase i did not understand it. can you please reply.
doctor
Answered by Dr. Sameer Kumar 2 minutes later
Brief Answer:
Anembryonic gestation...explained

Detailed Answer:
Hello,
Thanks for the follow up,

This simply means that the baby has not started forming at all. The appearance of foetal pole is the start of formation of the baby first and then comes the heart beat and then the baby grows further.
Now as there is no foetal pole, this is an empty gestational sac with NO BABY in layman's terms . This foetal pole should ideally arrive by 7 weeks or by XXXXXXX 8 weeks depending on the serial hcg levels.
An empty sac is called an embryonic or chemical pregnancy.
Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Sameer Kumar

OB and GYN Specialist

Practicing since :2002

Answered : 1656 Questions

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