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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Recommended For Pregnancy Termination Due To Lack Of Heartbeat. No Symptoms Of Miscarriage. What To Do?

hello, i have no symptoms of miscarriage , in fact have all pregnancy symptoms which have increased steadily. today at ultrasound , baby measure exactly on schedule (7w 4d) but no heartbeat found. doctor recommends termination. I am confused how baby could grow on track and not have a heart?? is there possibility of error?
Sun, 31 Mar 2013
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General & Family Physician 's  Response
Hi and thanks for the query,
Symptoms of miscarriage, especially in very early stages of pregnancy could even last for over 3 weeks or even more before becoming clinically apparent. The obstetric ultrasound at 7 weeks should be enough to make a definitive diagnosis, with respect to the vitality of the fetus or not. Its normal that there could be errors, but extremely rare in case the examination is done by an experienced echographer/radiologist. It could be worth repeating, but if there is no heart beat, it would be worthwhile terminating the pregnancy. Chromosomal analysis of the remains should be done and a complete infectious screen run again. Consult your obstetrician and hope this is of help.
Best regards,
Luchuo, MD.
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OBGYN Dr. Aarti Abraham's  Response
Hello
Thanks for your query.
When the fetal heartbeat fails to show by a certain size of the fetus, it is called a missed abortion.
at 7 weeks and 4 days, the cardiac activity of the fetus should have been visualized.
If not, then it is a missed abortion, and you have correctly been recommended for termination of pregnancy.
Just to reassure yourself, take a second opinion.
Make sure the ultrasound done is transvaginal on an empty bladder.
If the picture is still the same, please go for termination of pregnancy.
There could be various causes for this.
Make sure that the products of conception are sent for detailed analysis.
take care.
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Recommended For Pregnancy Termination Due To Lack Of Heartbeat. No Symptoms Of Miscarriage. What To Do?

Hi and thanks for the query, Symptoms of miscarriage, especially in very early stages of pregnancy could even last for over 3 weeks or even more before becoming clinically apparent. The obstetric ultrasound at 7 weeks should be enough to make a definitive diagnosis, with respect to the vitality of the fetus or not. Its normal that there could be errors, but extremely rare in case the examination is done by an experienced echographer/radiologist. It could be worth repeating, but if there is no heart beat, it would be worthwhile terminating the pregnancy. Chromosomal analysis of the remains should be done and a complete infectious screen run again. Consult your obstetrician and hope this is of help. Best regards, Luchuo, MD.