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Gynecology (Expert Forum)
6W3D pregnant, but no fetal pole found
Answered by
Elaine Brown, MD - Pregnancy, Gynecology
Elaine Brown, MD - BLOG
Billings - MT
6W3D pregnant, but no fetal pole found
by JT1078, Oct 18, 2009 12:11PM
Hi,
I was what I calculated to be 6 weeks and 3 days pregnant when I went to the ER for cramping on one side and minimal spotting (was concerned about an ectopic pregnancy since I had a cyst removed a few years ago). From an u/s, the docs found the gestational and yolk sac to be in the uterus, but they saw no fetal pole. Based on the measurements of the sac (which they didn't list in the results) and the fact that no fetal pole was identified, they determined the gestational age to be 5 weeks and 3 days. My HCG level is 13,850 miUs and there was no free fluid identified. I truly don't think conception was off by a week because my cycle has always seemed to be a regular 28 days.
So my two questions are: 1) Is it possible that if I normally have a regular cycle that I could be a week off (ovulated late) on the gestational age? If I was 5 wks 3 days, I think my results would be normal, which is what I'm hoping for. 2) Is it possible at 6 wks 3 days that the docs couldn't see the fetal pole, but it's actually there? I do have a retroverted uterus, and I've read that sometimes it's harder to identify the fetal pole earlier in that case. Would my HCG level of about 14k correspond to a 6 wk 3day g.a. or is that too low?
I have my initial appt with my OB on Tues, so I guess time will tell, but I'm going crazy right now waiting. Plus, I'd like another opinion.
Thanks!
I was what I calculated to be 6 weeks and 3 days pregnant when I went to the ER for cramping on one side and minimal spotting (was concerned about an ectopic pregnancy since I had a cyst removed a few years ago). From an u/s, the docs found the gestational and yolk sac to be in the uterus, but they saw no fetal pole. Based on the measurements of the sac (which they didn't list in the results) and the fact that no fetal pole was identified, they determined the gestational age to be 5 weeks and 3 days. My HCG level is 13,850 miUs and there was no free fluid identified. I truly don't think conception was off by a week because my cycle has always seemed to be a regular 28 days.
So my two questions are: 1) Is it possible that if I normally have a regular cycle that I could be a week off (ovulated late) on the gestational age? If I was 5 wks 3 days, I think my results would be normal, which is what I'm hoping for. 2) Is it possible at 6 wks 3 days that the docs couldn't see the fetal pole, but it's actually there? I do have a retroverted uterus, and I've read that sometimes it's harder to identify the fetal pole earlier in that case. Would my HCG level of about 14k correspond to a 6 wk 3day g.a. or is that too low?
I have my initial appt with my OB on Tues, so I guess time will tell, but I'm going crazy right now waiting. Plus, I'd like another opinion.
Thanks!
Doctor's Answer
by Elaine Brown, MD, Oct 21, 2009 10:47AM
, Oct 21, 2009 10:47AMTo: JT1078
Hi!
It is always possible to be off by a few days. If you ovulated 3 days late, and the ultrasound was off by 3 days, that could account for the difference. To me, your lab findings sound good. I'll bet that when you see your doctor and get your next scan, they will see a fetal pole and fetal heart beat. It IS harder to evaluate a retroverted uterus, and ER scans are almost always sub-optimal. I think you will be OK!
Congratulations!
Good luck!
Dr B
It is always possible to be off by a few days. If you ovulated 3 days late, and the ultrasound was off by 3 days, that could account for the difference. To me, your lab findings sound good. I'll bet that when you see your doctor and get your next scan, they will see a fetal pole and fetal heart beat. It IS harder to evaluate a retroverted uterus, and ER scans are almost always sub-optimal. I think you will be OK!
Congratulations!
Good luck!
Dr B
