6.3 weeks u/s no fetal pole or heartbeat

Hi, I've posted this on another area of the forum but would like a doctor's advice. I had a vaginal ultrasound yesterday at 6.3 weeks since LMP and while the u/s showed a clear gestational sac it did not show a fetal pole or heart beat. I have had no spotting (I know this is normal for blighted ovum) and all pregnancy symptoms (also know this is normal for blighted ovum). My HCG #s yesterday were 34,476 and I will get them repeated tomorrow along with a follow-up ultrasound next Friday, when i will be 7w4d.

My question for you is how common is it to have an u/s at 6.3 and NOT see fetal pole or heartbeat? Everything I have been reading suggests that both SHOULD have been visible transvaginally. I am preparing for an unfortunate outcome and we are at peace with this, albeit very sad. But do you see u/s at 6.3 with no fetal pole / heartbeat only to be followed at 7.4 WITH fetal pole and heartbeat? Or is that rare?

Thank you

[Keith Downing, MD]

Hello,

As you note, at the gestational age you were noted to be (6.3 weeks) and at the hCG level noted (34,476), a fetal pole with a + fetal heart rate is to be expected.  There are always exceptions, but I'd say the likelihood of you having a viable pregnancy is quite low.  One helpful sonographic finding would be the mean sac diameter.  If it is greater than ~18mm with no fetal pole it is essentially guaranteed to be a failed pregnancy.

Best regards,

Dr. Downing

[babylove144]

A related discussion, 6.1 weeks pregnant and no fetal pole was started.