Emotional Rollercoaster...

QUESTION

Dear Ms. Ultrasound,
Hello, I am 37 years old and I am pregnant with my third child. I have been put through an emotional roller coaster this past few days.

First I took a pregnancy test and it was Positive!!! I went to a clinic and the pregnancy was confirmed. I thought at this point that I was around 7 weeks pregnant from LMP. I then made an appointment for a sono for 8 weeks.

I then returned so excited to say hello to my little baby. I had the sono with the gestational sac and yolk sac very visible but there was not a fetal pole or heartbeat at this time and I measured to be 6 weeks and 5 days not as far along as I initially thought.

I was then told that my sono was inclusive and that I should see an OB/GYN immediately and was handed miscarriage and ectopic pregnancy instructions. They also informed me to go to the hospital immediately if I had an cramping or bleeding at all. I have not had either to this day.

I then scheduled and appointment with my OB/GYN the next day. I explained what had occurred and she wanted to do blood work to check my hcg levels. My levels were at 36,000. I received a phone call from the nurse the next day telling me my levels were very high at 36,000 and that it is very important that I get another sono immediately and if I have any cramps or bleeding over the weekend to go the hospital.

That was Friday and still no signs of cramps and no bleeding. I am scheduled for another sono Monday and I am a nervous wreck that I am not going to see a fetal pole or heartbeat again. I have tried really hard to stay calm and positive but it is really hard. What is your expert opinion?

ANSWER

Hi, With an HCG level at 36,000 you must see a fetal pole with a heartbeat for this pregnancy to be progressing normally. If at the next ultrasound there is no fetal pole in the gestational sac the pregnancy has stopped growing. A yolk sac within the gestational sac rules out the possibility of an ectopic pregnancy ( unless you are the one in forty thousand that have a twin pregnancy, with one in the tube and one in the uterus) Since we are going to say you are not the one in forty thousand, this is not an ectopic.

The next ultrasound will give you your answer one way or another.

With regards,
-- Jane RDMS

Jane Foley

Jane Foley has worked as a Sonographer (Ultrasound Technologist) since 1979. Jane has lived and worked in many parts of the world including Saudi Arabia. She is a Registered Diagnostic Medical Sonographer or RDMS. She pulls a wealth of information from her experience in the field of Radiology and her interactions with such a broad cross-section of cultures she has visited. She now makes her home on the island of Maui with her English husband, Michael.