Weird Results at 8 Week Ultrasound

[moxielou]

I had an ultrasound today at 8 weeks. I've never had an early ultrasound before but I'm coming off of 3 losses in a row (see my siggy).

We did the first ultrasound in the DR's office, and we saw a heart beat and everything measured close to what I expected (7 weeks 3 days they said). But then the Dr said he was sending me downstairs to radiology because "something else" was in there.

So we went to Radiology, had an ultrasound then had the fun transvaginal one. (The lab tech showed it to me and said, "Have you met Mr. Probe before?" lol!) We did the Vaginal one, she brought my OB back into look, then the Radiologist came into look. I had a probe up in me and there are three medical people staring at the screen looking befuddled, and all I can think is "Now What?!?!?!?!"

Of course they didn't tell me anything forever. Back in the office, the OB/Gyn told me that according to the Radiologist, he said the "other thing" was a baby with no heartbeat; he thought so because he said it was shaped like a baby and it was in the same sac as the viable heartbeat one. (Which means I had twins and now I don't which means one more baby to mourn though at this point, I'm putting it in the queue--as horrible as that sounds).

Now that's not all that unusual except the non-viable one is twice as big as the viable one That my OB was very puzzled by. He seemed alarmed that it was that much bigger. If there were twins, the "big one' is the one that failed. Why is it bigger? Does bigger mean something was wrong with it?

and of course the big question for me is: what does it all mean for the little viable peanut?

has anybody ever heard of anything like this?

[scifimama]

i don't have any advice for you mama. just s

[CorasMama]

you're right, that is weird. I don't have any advice for you, but I would assume that if there was a significant risk to the viable fetus, your doc would have mentioned that. At least, mine would have, but she doesn't pull any punches (at my request.)

[IAMommy]

As I understand it, it is very common to conceive twins and then have one not make it early on. They think it is more common than anyone ever knew before. As long as the living baby is healthy, it will probably be fine.
They said the non-viable baby was large, but did they say if the living one is measuring right for dates?
Your doctor needs to explain this better.

[beachlover]

Usually vanishing twins, as they are often called, are reabsorbed(as horrible as that sounds)and the pregnancy continues with a happy singleton.

I'm guessing your OB, probably hasn't seen this happen before with the unviable being larger than the viable, so doesn't really know what to expect. But that doesn't mean it won't reabsorb just like it should.

Is he having you come back next week for another look to see how things are progressing?

[organicpapayamama]

ok so your post is a bit puzzling. and first off if that IS a twin Im terribly sorry for your loss. But it seems that they are only guessing... having said that, are they 100% sure it is in the sac? Reason I ask is because after I lost my daughter a month later I passed something... No one was sure what it was. I had just stopped my postpartum bleeding and I felt something come out. There was no way I was pregnant as my dh at the time and I had not dtd. what came out was a fleshy ball in the shape of a very large jumbo shrimp... like an early fetus. I took it to the OB and had her look at it and she couldnt tell me what it was. I had had several ultrasounds with the pregnancy that I lost and they never once told me I had any fibroids yet she said it was probably a fibroid that had come out on its own... though she couldnt be sure. So I will never know if it was a baby or just tissue. It really looked like a fetus to me though.... at any rate perhaps what they are looking at is a fibroid... Its just a guess though but it seems thats all they are doing as well. I hope you get some answers.

[katec67]

I just read a similar story on Abby Epstien's blog (BOBB director). Here is the link. The mystery was never really solved, but she did end up with a healthy baby in the end. Good luck to you!

http://www.mybestbirth.com/profiles/...pecting-part-1

[moxielou]

Thanks for the hugs and advice.

The viable heartbeat baby was measuring at 7 weeks 4 days; by my calculation I'm 8 weeks exactly so that is within the margin. So the baby with the heartbeat is right for size which is, I know, very good news. And the heartbeat was good. (though truth be told, they spent more time looking at the mystery shape).

It's possible that it's not in the sac. That was based on the radiologist's assessment. He said that it was in the sac and, to his, eye, it looked like a baby. He didn't tell me this, it was all relayed to my OB. So I'm going on his word and I don't know him, but the OB did seem to trust him 100%.

My OB referred me to another office who can do 3-D ultrasounds to get a better look. He said we can go anytime, but we may want to wait a week or more to get a sense on how the baby is growing.

I know money doesn't matter, but we'll be paying out of pocket for all these ultrasounds since we have a High Deductible Plan. I was already planning on getting the 3-D ultrasound at 12-13 weeks to look for chromosonal markers since I am "of advanced maternal age" (I'm 39). It does seem impossible to wait a month for another look, though!

Thanks for the link to Abby's blog; it's good to see someone else's experience.

[2boyzmama]

There is another possibility, although very far-fetched, it has happened in medical literature, and I thought may have been happening to me, so I researched it a bit.

Twins of different gestational ages.

On very rare occassion, a woman's body won't get the signal that she's pregnant, and will still ovulate. If that second ovulation is fertilized and manages to implant into the uterus, then you could have fraternal twins approx 4 weeks apart in age.

We suspected this with me because I had an ultrasound at 10 weeks, it showed one healthy 10 week fetus and one apparently healthy yolk sac measuring about 6 weeks. The dr said that we wouldn't know until the next month whether the second sac was an absorbing (vanishing) twin or if it was still developing and was exactly one month younger. (in my case, the second sac reabsorbed and I had a singleton)

That being said, they shouldn't be in the same 'sac'. They should be dizygotic and diamniotic, with two placentas, two amniotic sacs. If they share a placenta, then they were conceived at the same time (or near to the same time) and if they share an amniotic sac, that creates a whole new set of risk factors (monoamniotic twins are very risky).

You should ask for a copy of the radiology report. Look for information on how many placentas they saw. How many amniotic sacs. Whether they observed any blood flow to the other baby. Whether the blood flow to the viable baby was normal. Whether they saw any recognizable organs in the non-viable baby (at that size, there should be organs). Look for the word "hydrops" which might explain the size.

Did your dr recommend CVS or Amnio? Would you consider doing either one if it's indicated? You might want to decide that now so you aren't blindsided or rushed into a decision.

Questions to ask about the viable baby would be things like blood flow, organ development, is there any risk of cord entanglement if they think the babies share a sac, is the non-viable baby "stealing" nutrients if they share a placenta...

[organicpapayamama]

Originally Posted by 2boyzmama

There is another possibility, although very far-fetched, it has happened in medical literature, and I thought may have been happening to me, so I researched it a bit.

Twins of different gestational ages.

On very rare occassion, a woman's body won't get the signal that she's pregnant, and will still ovulate. If that second ovulation is fertilized and manages to implant into the uterus, then you could have fraternal twins approx 4 weeks apart in age.

We suspected this with me because I had an ultrasound at 10 weeks, it showed one healthy 10 week fetus and one apparently healthy yolk sac measuring about 6 weeks. The dr said that we wouldn't know until the next month whether the second sac was an absorbing (vanishing) twin or if it was still developing and was exactly one month younger. (in my case, the second sac reabsorbed and I had a singleton)

That being said, they shouldn't be in the same 'sac'. They should be dizygotic and diamniotic, with two placentas, two amniotic sacs. If they share a placenta, then they were conceived at the same time (or near to the same time) and if they share an amniotic sac, that creates a whole new set of risk factors (monoamniotic twins are very risky).

You should ask for a copy of the radiology report. Look for information on how many placentas they saw. How many amniotic sacs. Whether they observed any blood flow to the other baby. Whether the blood flow to the viable baby was normal. Whether they saw any recognizable organs in the non-viable baby (at that size, there should be organs). Look for the word "hydrops" which might explain the size.

Did your dr recommend CVS or Amnio? Would you consider doing either one if it's indicated? You might want to decide that now so you aren't blindsided or rushed into a decision.

Questions to ask about the viable baby would be things like blood flow, organ development, is there any risk of cord entanglement if they think the babies share a sac, is the non-viable baby "stealing" nutrients if they share a placenta...

great info but she did mention that they other "baby" did not have a heartbeat. So it would be more like the link to the article where perhaps it was a vanishing twin.

[2boyzmama]

Originally Posted by organicpapayamama

great info but she did mention that they other "baby" did not have a heartbeat. So it would be more like the link to the article where perhaps it was a vanishing twin.

What I'm saying is it could still be a vanishing twin, of a different gestational age (the older twin became non-viable). That *might* explain the differing sizes.