Dilly Posted June 27, 2007 Share Posted June 27, 2007 So my SIL is sort of 6.5 or 7.5 weeks (as measured by the first day of the last menses - my brother and SIL disagree on the FD-LMP) pregnant. I say sort of because here's the data in support of pregnancy: positive home pregnancy test HCG levels continue to rise ultrasound reveals placenta Then, there's the doctor that did her ultrasound at six weeks and told her that she needs to schedule a D&C because she has an abnormal pregnancy. There's no baby in the sac he says, no heartbeat. I'm just confused because I didn't think the heartbeat was detectable until 8 weeks. Could that doc that recommended the D&C be wacko? She goes for a second US this Monday. Link to comment Share on other sites More sharing options...
shyshutterbug Posted June 27, 2007 Share Posted June 27, 2007 Nope. You can see a heartbeat on ultrasound as early as 5 1/2 weeks, and you should be able to see one at least by 6 weeks. If she's that far along and there is no heartbeat, she's had what's called a "missed abortion" (translation: she's miscarried, but without passing any tissue). Her doc is right. She needs a D&C. Link to comment Share on other sites More sharing options...
CarnelianButterfly Posted June 27, 2007 Share Posted June 27, 2007 I've read that its as late as the 9th to 10th week, the heart may start beating in the 5th week, but its far too small to hear even with the amplification of the equipment. Note: The usual equipment being a Doppler machine that requires the sound waves to be bounced off the heart at just the right angle. This is VERY hard to do and is mostly luck. The pulse is best heard by the 12th week, when its strong and steady. Link to comment Share on other sites More sharing options...
shyshutterbug Posted June 27, 2007 Share Posted June 27, 2007 Sorry, I just reread your post, and I'm a little confused. Did the doctor say there's "no baby in the sac" or "no heartbeat"? There has to be a baby there in order for there to be no heartbeat. If there's no heartbeat, then my earlier post was right, but if there's nothing at all within the gestational sac, it's what's called a blighted ovum, which means no embryonic tissue developed at all. Regardless, she still needs the D&C. Keeping that tissue in her uterus is extremely hazardous to her health. Carnelian - you're absolutely right about the dates for hearing a heartbeat, but doctors base it on what they can see on ultrasound. Heartbeats during early pregnancy are visible, as a tiny blinking dot in the middle of the embryo. If the doc can't see one, the pregnancy is not viable. Being able to actually hear a heartbeat is kind of a luxury at this stage in a pregnancy. Link to comment Share on other sites More sharing options...
Dilly Posted June 27, 2007 Author Share Posted June 27, 2007 Hey Shyshutterbug, THANKS!!! Tell me more. It sounds so heart-breaking. I was kind of hoping the doc was just an jack's behind. But darn. A blighted ovum, huh? Any idea on how that might have happened? SHe's had one prior miscarriage. The only thing I can think of from my research is progesterone levels are off. Link to comment Share on other sites More sharing options...
Dilly Posted June 27, 2007 Author Share Posted June 27, 2007 But why would her HCG keep skyrocketing!!!??? Link to comment Share on other sites More sharing options...
shyshutterbug Posted June 28, 2007 Share Posted June 28, 2007 Not at all I swear, I can't even separate myself from my work even on my day off, lol... Any one of a million things can cause a blighted ovum, just as any one of a million things can cause a miscarriage. The exact cause usually can't be determined. If she's had a prior miscarriage, that might increase her risk, but probably very minimally. A doctor is tipped off to a blighted ovum if they see nothing but a gestational sac on ultrasound, without a yolk sac or pregnancy within it, and if the sac is measuring over about 5 weeks. A blighted ovum is essentially a miscarriage before a pregnancy even has a chance to grow. They're pretty rare, but I've seen several on ultrasound. The longer that tissue stays in her uterus, the more vulnerable it will be to getting infected, which is why her doc is recommending the D&C. Her hCG would keep rising because the tissue is still in the uterus. Regardless of whether there's a pregnancy there or not, there's pregnancy tissue there - the gestational sac - and that's going to result in a positive pregnancy test just as much as an actual pregnancy would. Link to comment Share on other sites More sharing options...
Aleadragonhawk Posted June 28, 2007 Share Posted June 28, 2007 The elevated HCG is mentioned in this article - link removed Link to comment Share on other sites More sharing options...
shyshutterbug Posted June 28, 2007 Share Posted June 28, 2007 That's one of the best (and, mercifully, easiest to understand) articles on blighted ova I've ever seen. Thanks for the link, Aleadragonhawk! Link to comment Share on other sites More sharing options...
RayKay Posted June 28, 2007 Share Posted June 28, 2007 I was going to say "sounds like a blighted ovum" and then I saw another poster already did (and one whom obviously knows far more than I do about this!). You will still get positive HCG tests, and a gestational sack, but it is empty (except for fluids). The HCG will keep increasing as the body still believes there is a pregnancy due to the sack....but it is definitely NOT healthy for her to keep going like this and she does need the D&C. And yes, they can see the heartbeat around that period. As for why they happened...they just "do" at times. It is not terribly common, though I do have a friend whom had the same. Basically it is an early miscarriage, but the placenta and gestational sack continue to grow anyway despite the fetus being lost. Link to comment Share on other sites More sharing options...
BornToResist Posted June 28, 2007 Share Posted June 28, 2007 How devestating! I know this is probably going to sound terribly insensitive, but I saw a Law & Order on this before I think...there was a pregnant homeless woman and they took her to the doctor to get her checked out for whatever reason and there was no baby...it was so sad. Anyways. I didn't think that could really happen and that is so scary. Link to comment Share on other sites More sharing options...
Ash Posted June 28, 2007 Share Posted June 28, 2007 I've read that its as late as the 9th to 10th week, the heart may start beating in the 5th week, but its far too small to hear even with the amplification of the equipment. Note: The usual equipment being a Doppler machine that requires the sound waves to be bounced off the heart at just the right angle. This is VERY hard to do and is mostly luck. The pulse is best heard by the 12th week, when its strong and steady. Just wanted to comment on this. It may not be possible to HEAR a heartbeat using a doppler but it is entirely possible to SEE a heartbeat on ultrasound. The equipment used check for a heartbeat this early in a pregnancy is an ultrasound machine. That aside, this sounds like a really unfortunate incident. The date for the second US is quite close, hopefully if the first doctor is correct and a D&C is necessary then waiting the extra few days won't cause an additional health risk. If that's so, and it were my potential baby then I'd certainly want a second US if the additional risk of waiting was not too high. Link to comment Share on other sites More sharing options...
southerngirl Posted June 28, 2007 Share Posted June 28, 2007 I have nothing further to add to this other than to say that I am very very sorry for this loss. She is going to need lots of your love right now. Link to comment Share on other sites More sharing options...
BellaDonna Posted June 28, 2007 Share Posted June 28, 2007 I'm sorry to hear this. I'm sure it's difficult for her. Losing a pregnancy, regardless of the cause, is never easy. If I had any advice to give, it would be to really "lay low" for a while when it comes to talking about baby stuff. I'm sure you know this already. I just remember after miscarrying, seeing other pregnant women or moms with new babies was very difficult for a while. I wondered why it could all work out "for them" and not for me. Even now when I go to my doctor's office I try to be very neutral, if that makes any sense. Even though I'm very obviously pregnant- I try not to look too excited or smile all that much because I wonder how many women in the waiting room might have problem pregnancies or be experiencing a miscarriage, etc. I try to "lay low". Just let your SIL know you are there for her. Link to comment Share on other sites More sharing options...
Dilly Posted July 3, 2007 Author Share Posted July 3, 2007 THANK YOU ALL SO MUCH! You all are such great family!!! She got her ultrasound yesterday and sure enough, there's no baby. She is probably undergoing her second D&C today (since February). I do feel sorry for them, but ... they will get through this. My two brothers and I are each about a year apart. My younger brother had his baby two years ago February. I had mine in April. Chris was trying to keep up the pattern by having one next February. Since he's about 17 months older, I predict he'll have his baby in September, 2008. THANKS AGAIN - it is sorta hard being joyful about my baby around them right now. But they are so happy for me. Link to comment Share on other sites More sharing options...
RayKay Posted July 3, 2007 Share Posted July 3, 2007 Thanks for the update, though of course sorry about the news turning out to be as was suggested here. I will send them good thoughts and hopes for a healthy pregnancy and baby to come their way soon. Link to comment Share on other sites More sharing options...
Dilly Posted July 6, 2007 Author Share Posted July 6, 2007 THANKS RAYKAY!!! I know from personal experience those vibes are powerful (the ones that emanate from your brain)! Link to comment Share on other sites More sharing options...
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