5w4d u/s - what to expect? *Update in #16 and new ?? re: HCG drop*

[kalamos23]

I know this is super early, and I'm not expecting more than a ges sac and yolk - but what did you all see on your early u/s if you had one? I tried to get it scheduled later but teh OB wouldn't due to bleeding I had yesterday and the holidays.

[sarahn4639]

I have no idea why your OB would want to do one. You're not going to see much of anything and it won't tell you one way or the other about the bleeding. Even if you don't see much, it can't say for sure that a miscarriage is happening. Personally, I would refuse the ultrasound and schedule a new one in a week or 2 so you have a better chance at seeing a heartbeat. I'm sorry, I've been there with the early bleeding and mine didn't end well (though many, many times it does!!) For me, an ultrasound that didn't confirm a live baby (heartbeat) would do nothing but cause me further stress. Without any benefit, I don't see the point. The only way I would consent at this point is if you are having symptoms of an ectopic, you'd want to catch that as early as possible.

Many good sticky baby thoughts for you!!

[Carolinamom4]

You are right, you should see a sac, maybe yolk. Don't worry if you don't see much. It is really early. Probably making sure the sac is in the right place because of the bleeding and your past history. Good luck!

[kalamos23]

Originally Posted by sarahn4639

I have no idea why your OB would want to do one. You're not going to see much of anything and it won't tell you one way or the other about the bleeding. Even if you don't see much, it can't say for sure that a miscarriage is happening. Personally, I would refuse the ultrasound and schedule a new one in a week or 2 so you have a better chance at seeing a heartbeat. I'm sorry, I've been there with the early bleeding and mine didn't end well (though many, many times it does!!) For me, an ultrasound that didn't confirm a live baby (heartbeat) would do nothing but cause me further stress. Without any benefit, I don't see the point. The only way I would consent at this point is if you are having symptoms of an ectopic, you'd want to catch that as early as possible.

Many good sticky baby thoughts for you!!

I 100% agree with you - I tried to refuse the ultrasound and just have the beta tomorrow and the nurse was all like, well we can't get you in until Wednesday ... which was fine with me. I am not having any symptoms of an ectopic so I'm not concerned about that. It's too late to call tonight and the u/s is scheduled for 10:45 tomorrow morning so what do I do, just call tomorrow and reschedule? I'd much rather go in in a week or 2 and see a heartbeat but I'm also on progesterone and I need a refill by Wednesday, so I don't want to piss them off too much.

That being said, I did tell her my sister is flying in tomorrow and the times clashed (they don't really, it will be close but not bad) so I could beg off with not being able to find someone to pick up my sis?

[kalamos23]

I should add, I had a beta yesterday that came in at 3750 at 23dpo, and will have another one tomorrow so that should tell more if they are going up than an u/s would, I would think. I had an u/s at 7w2d with my last pregnancy, saw a heartbeat and everything, baby measured ahead and we still lost the baby, so even seeing the heartbeat isn't going to destress me, kwim?

[nova22]

I had an u/s at 5 weeks. I knew I was 5 weeks. My chart said I was 5 weeks. My doctor didn't believe me for some reason. *Sigh* If the radiologist is off in his/her measurements by as little as a millimeter at this point in your pregnancy, it can throw off your measurement by a week. My radiologist said I was 7 weeks pregnant and since she saw no heartbeat, she wrote it off as fetal demise. The next day I got a call from my OB to schedule a D&C. I refused and demanded a second u/s two weeks out. He was hesitant but finally gave in, told me to look for signs of infection just in case, and in two weeks we saw a very clear heartbeat. Based on that experience I *personally* would refuse another early ultrasound because I wouldn't want a mis-measurement to cost a healthy baby's life, KWIM? In your position I might call in sick and tell them you're sorry but you absolutely must reschedule. Whatever you do I hope your radiologist will treat you with respect, it's always easier to have a transvaginal u/s when your radiologist is gentle and nice!

[WTHamI?]

Originally Posted by nova22

I had an u/s at 5 weeks. I knew I was 5 weeks. My chart said I was 5 weeks. My doctor didn't believe me for some reason. *Sigh* If the radiologist is off in his/her measurements by as little as a millimeter at this point in your pregnancy, it can throw off your measurement by a week. My radiologist said I was 7 weeks pregnant and since she saw no heartbeat, she wrote it off as fetal demise. The next day I got a call from my OB to schedule a D&C. I refused and demanded a second u/s two weeks out. He was hesitant but finally gave in, told me to look for signs of infection just in case, and in two weeks we saw a very clear heartbeat. Based on that experience I *personally* would refuse another early ultrasound because I wouldn't want a mis-measurement to cost a healthy baby's life, KWIM? In your position I might call in sick and tell them you're sorry but you absolutely must reschedule. Whatever you do I hope your radiologist will treat you with respect, it's always easier to have a transvaginal u/s when your radiologist is gentle and nice!

I totally agree with this, and personally do not see the point in getting an ultrasound that early at ALL. I have known many people who have been told by a doctor/ultrasound tech that they did not have a viable pregnancy when really it was just too early and things were fine. Even with bleeding I would refuse...an ultrasound at 5 weeks is never going to prevent a loss so I personally do not see the point. I do pray everything is okay. But I doubt an ultrasound is really helpful so early either way.

[pugmomma]

I have one fallopian tube so it was really important to make sure that it was an ectopic preganacy as soon as possible. I had an ultrasound at 5 weeks and 5 days. They couldn't see the yolk sac so they had to do another one at 6 weeks and 1 day. We saw the heartbeat then. I would say for woman who have uneventful pregnancies or no problems getting pregnant then it would be fine to wait for ultrasounds until later. However, we have been trying to conceive for over a year so I have no problem going to the doctor to make sure everythings okay.

[lunarlady]

It isn't going to be pleasent early on no matter what, because they are going to have to go in vaginally, and that is never that pleasent. I'm guessing that you won't see much. They may be looking for the ovarian cyst and sack, just to confirm pregnancy. It is very hard to see the heartbeat before 6 weeks, so you most likely won't.

If your sister is flying in, I would just call and reschedule for Tuesday. That way they might actually see the heartbeat, which is a more firm confirmation of pregnancy anyway. Good luck!

[JFTB1177]

Originally Posted by nova22

My radiologist said I was 7 weeks pregnant and since she saw no heartbeat, she wrote it off as fetal demise. The next day I got a call from my OB to schedule a D&C. I refused and demanded a second u/s two weeks out. He was hesitant but finally gave in, told me to look for signs of infection just in case, and in two weeks we saw a very clear heartbeat.!

OMG!! What OB would have you schedule a D&C so early??? I have had 4 miscarriages, two were early and spontaneous, and two were later in the 1st trimester. With the ones that were later, my doc let me come in for weekly u/s's and would NOT do anything until he was 100,000% sure the baby had passed!! With my 4th loss I started spotting early on, and I went in to make sure it wasn't ectopic. We did finally see a hb a couple of weeks later, but it was very low... each week it got lower and lower- it was obvious the pregnancy was doomed. Baby was also measuring almost 2 weeks behind. But my doc absolutely refused to do a D&C until he was sure the baby had passed.

To the OP- I'm so sorry you're going through this right now. I've btdt that so many times. I know how hard it is waiting to have an u/s but the PP is right, all of the u/s's just ended up causing me so much stress. Do whatever makes you feel better. To give you some hope, while I did spot with my m/c's, I also BLED (a LOT- brown and bright red) with my 2 sons!!! Bleeding doesn't always mean a m/c! BIG HUGS!

[NoraFlood]

I had an ultrasound at 5w5d because I was having some spotting and wanted to make sure the pregnancy wasn't ectopic. I saw a gestational sac, a yolk sac, and the faintest, faintest beginnings of a heartbeat (although it wasn't anything distinct enough for the doctor to even get a heart rate or anything). No fetal pole. I wouldn't say it's necessarily not worth doing ever--there are definitely things they can tell from the size of the gestational and yolk sacs, and of course knowing that it's intrauterine is valuable. But it's true that there isn't MUCH they can tell, and if you can stand it maybe it would be better to wait a week or so. I have to say that I found that early ultrasound to be very reassuring though, and I don't regret getting it.

[~Adorkable~]

I had my first us at 6w4d and that was for extreme cramping so to check for ectopic, everything was fine

I think that I found interesting was that once they saw the heartbeats, they were very quick to get off that area and focus on them, they said they did not like to sit onto of e heart when it was so young and would not stop and listen to it for a few more weeks, just an extra precaution on such a small new heart.

Seeing as this is a very medicalised RE, their concern for extra safety was nice to see, they thought u/s were safe but extra care was warranted in those very early weeks.

Even though I would have loved to hear them, I'm glad I had what was a quicker on the safe side appointment.

[JFTB1177]

Wanted to add one more thing... here is a link that was very helpful to me when I was having all of those early u/s's... (shows when yolk sac, hb should appear on u/s, etc).

http://www.babymed.com/pregnancy-sym...vels-pregnancy

[nova22]

Originally Posted by JFTB1177

OMG!! What OB would have you schedule a D&C so early??? I have had 4 miscarriages, two were early and spontaneous, and two were later in the 1st trimester. With the ones that were later, my doc let me come in for weekly u/s's and would NOT do anything until he was 100,000% sure the baby had passed!! With my 4th loss I started spotting early on, and I went in to make sure it wasn't ectopic. We did finally see a hb a couple of weeks later, but it was very low... each week it got lower and lower- it was obvious the pregnancy was doomed. Baby was also measuring almost 2 weeks behind. But my doc absolutely refused to do a D&C until he was sure the baby had passed.

I'm glad to know it isn't common practice. The worst part of it was that I had never even met this doctor. I was working with a resident who reported to the doctor that ordered the D&C. He never saw me, talked to me, or looked at my charts. I was furious. Months later when I was in premature labor at 33 weeks, he was the doctor on call at the ER. I had never actually met him and wasn't looking forward to it at all. Fortunately my favorite doctor happened to show up even though she wasn't on call and she offered to see me since she knew my history. I feel like I dodged a bullet there.

[bella99]

I had an ultrasound with my daughter at 5w 5d at my RE's office. My dates were right on and the measurements were right on track. We saw a heartbeat of 111. But I was prepared to see nothing but a yolk sac and fetal pole with no heartbeat.

I had follow-ups at 7 and 8 weeks before being released to my OB.

They were all trans-vaginal and while I don't find them convenient, I must be strange, because I don't really mind them at all. Maybe because I've had so many.

[kalamos23]

I don't mind the trans vag either actually, I just really didn't want bad news again, but that is what we got. Huge bleed in the uterus that is dwarfing the ges sac. The ges sac itself is measuring 4w4d and I'm supposed to be 5w4d. We did see a yolk sac and what looked like the fetal pole, ges sac is round which is good, and that is about on par for 5w4d as far as development goes. However, HCG went from 3450 (they told me 3750 at 23dpo, but got it wrong) and dropped to 3329 today, so I don't have much hope. I thought possibly vanishing twin, but that is about the only thing I can think of at this piont that wouldn't be dire.

So the plan is to get a beta on Tuesday and continue the progesterone unless the beta goes down more and/or the u/s scheduled for the 12th shows no growth. I feel comfortable with this, I would think if it is doomed then that would be enough time to show growth or fetal demise.

That being said, has anyone had their HCG levels fall slightly (mine fell 121) and rebound?

[JFTB1177]

I'm so sorry. BIG HUGS I so so know that feeling. It could really go either way right now, and the worst part is the not knowing, right?

When I was going through my 4th loss I did come across a site about misdiagnosed m/c's that gave me some hope... it does happen. Here is the site: http://www.misdiagnosedmiscarriage.com/

Not trying to give you false hope but these stories got me through those days in between u/s's. I'll be thinking of you and I am crossing my fingers that your little one will beat the odds!

[~Adorkable~]

there was a lady a few days ago around here that showed a dropping HCG and the next week found out it was lab error. so just hand in, it sounds like you have a good plan, keep getting tested and take care of yourself, hugs

[Tear78]

oh Kalamos, I'm so sorry that your u/s didn't bring good news. I hope that Tuesday brings a great rise in hcg, a healthy baby, and peace of mind! and

[kalamos23]

So I found out that a significant SCH will cause compression of the gestational sac which is probably why the sac is measuring small but showing appropriate development. That being said, the bigger the SCH, the more grim the prognosis. I would guess that the gestational sac being compressed and therefore slightly smaller would cause a small drop in HCG as well. This is totally just a theory though, but I'm hoping and praying the SCH starts resolving - otherwise...