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sac and fetal pole but no hb
Technically, I am 8 weeks pregnant today, but at 7 weeks, I went to dr. for an u/s and was told I have a blighted ovum. My HCG levels were apprx. 7000 and there was a sac measuring 5 weeks, 4 days but no fetal pole and no hb. Four days later I went back for another u/s and bloodwork. HCG were apprx 53,000 (big jump), and the u/s showed growth from sac (measured about 7 weeks) and there was actually a fetal pole measuring about 6 weeks, but still not hb. My dr. says he is 115% sure this is not going to develop, and stated the growth is from high hormone levels. He strongly suggests D&C, but I am still not sure yet. Don't know if my uterus is retroverted, because when I asked I got an indirect answer. Has anyone ever heard of the fetal pole growing like that with a blighted ovum?
Since finding out last week, I too have been searching the internet non-stop and have yet to find someone saying their fetal pole grew, but I guess it could be my hormones like the dr. said. I am scheduled for another u/s on Mon, which will be 8 weeks, 3 days and he wants me to make a decision next week after the u/s. His concern is the difficulty I will experience by passing so much tissue since the fetal pole and sac are growing. I guess I won't be satisfied that this is not a viable pregnancy until I know my uterus is not retroverted and until I get a little further along. Because of all the stories I have found online, I am nervous to act too soon. I am also going to try to get a second opinion next week if possible. Thanks for your responses.
PLEASE READ THIS IT IS VERY IMPORTANT
What are the criteria for diagnosing a blighted ovum?
According to the Encyclopedia of Medical Imaging, the criteria for a diagnosis of blighted ovum are:
1) failure to identify an embryo in a gestational sac measuring at least 20 mm via transabdominal ultrasound.
2) Failure to identify an embryo in a gestational sac measuring approximately 18mm or more via transvaginal ultrasound.
3) Failure to identify a yolk sac in a gestational sac measuring 13mm or more.
Additionally, the outline of the sac may be irregular, incomplete or absent decidual reaction and/or fluid found in the gestational sac.
Are these criteria for finding a blighted ovum set in stone?
No, we at the Misdiagnosed Miscarriage do not believe so. We have seen a number of cases where either the baby or the yolk sac is not found within the gestational sac until the sac was bigger than these measurements.
What would account for the discrepancy?
We believe, based on the numerous stories that have found their way into the Misdiagnosed stories forum, that having a retroverted uterus may alter when you may see your baby via ultrasound.
What is a retroverted uterus?
A retroverted uterus, also known as a tipped or tilted uterus, is a uterus that tilts back toward the rectal area. In most women the uterus will tilt slightly forward toward the belly. Actually, having a retroverted uterus is quite common. Reports vary but approximately 20% to 40% of all women have a retroverted uterus. Because this is so common, doctors rarely mention if you have a tilted uterus unless you ask.
Why do you believe it is so difficult to find the baby via ultrasound?
Actually only during the early first trimester do we believe it may be a little more difficult to find the baby via transvaginal ultrasound. After talking to women and their ultrasound techs we've concluded that the positioning is more awkward when the uterus is retroverted and this makes viewing a bit trickier. There may be a possibility that when the baby lies parallel to the ultrasound beam, measurments may be off and the baby will appear smaller than he actually is. However, in the second trimester, measurements are generally more accurate in women with a tilted utersus.
I'd like to wait to end my pregnancy but is it safe?
According to the 'Journal of Family Practice' and other medical organizations, a woman can safely wait to miscarry naturally (or until she knows for sure there is absolutely no hope) if she:
1) does not have a fever
2) has stable vital signs
3) has no excessive pain
4) has no excessive bleeding
If you meet these four criteria, waiting before having a D&C or to have a natural miscarriage is a reasonable option. If you do not meet these criteria, you could be at risk for infection. Seek help immediately.
Okay, I can safely wait, but how long will I have to wait?
We've seen women who were diagnosed with a blighted ovum who only had to wait a week or two before miscarrying or finding their babies and others who needed to wait three or more weeks. We do know with some certainty that waiting only one week, especially if you are eight weeks or less is not enough time to be certain you have a blighted ovum.
But, doctors would never misdiagnose something as important as a miscarriage, would they?
Unfortunately, the answer is yes and we can say that with reasonable certainty because we get several cases a month on the website where a woman was misdiagnosed. In many of these cases, the misdiagnosed woman has already turned down the D&C at least once.
How often do you think a blighted ovum is misdiagnosed?
Honestly, the vast majority of diagnosed miscarriages are in fact miscarriages. We do believe, though, that a fairly large number of women who are diagnosed with a blighted ovum AND have a retroverted uterus are misdiagnosed especially if they are diagnosed at eight weeks or before.
They finally found my baby at 10 weeks but are telling me I am only 7 or 8 weeks but I know this is impossible. How can this be?
The measurements taken by transvaginal ultrasound are very accurate during the first trimester and used by physicians to date the pregnancy. However, they are subject to human error and, we believe, they are not quite as accurate if your uterus is tilted. We've had a number of women who knew exactly when they conceived but did not see their babies until 8 to 12 weeks (or even more) and, when finally found, their doctors insisted their dates were off by weeks. Even if the woman only had sex one time, they'll insist she got pregnant weeks later. We believe that with the awkward positioning during the ultrasound coupled with the tilted uterus, dates are skewed during the first trimester. And, in fact, most of these women report the dates as being accurate again at their 20 week (or second trimester ) ultrasound.
What are the criteria for diagnosing a blighted ovum?
According to the Encyclopedia of Medical Imaging, the criteria for a diagnosis of blighted ovum are:
1) failure to identify an embryo in a gestational sac measuring at least 20 mm via transabdominal ultrasound.
2) Failure to identify an embryo in a gestational sac measuring approximately 18mm or more via transvaginal ultrasound.
3) Failure to identify a yolk sac in a gestational sac measuring 13mm or more.
Additionally, the outline of the sac may be irregular, incomplete or absent decidual reaction and/or fluid found in the gestational sac.
Are these criteria for finding a blighted ovum set in stone?
No, we at the Misdiagnosed Miscarriage do not believe so. We have seen a number of cases where either the baby or the yolk sac is not found within the gestational sac until the sac was bigger than these measurements.
What would account for the discrepancy?
We believe, based on the numerous stories that have found their way into the Misdiagnosed stories forum, that having a retroverted uterus may alter when you may see your baby via ultrasound.
What is a retroverted uterus?
A retroverted uterus, also known as a tipped or tilted uterus, is a uterus that tilts back toward the rectal area. In most women the uterus will tilt slightly forward toward the belly. Actually, having a retroverted uterus is quite common. Reports vary but approximately 20% to 40% of all women have a retroverted uterus. Because this is so common, doctors rarely mention if you have a tilted uterus unless you ask.
Why do you believe it is so difficult to find the baby via ultrasound?
Actually only during the early first trimester do we believe it may be a little more difficult to find the baby via transvaginal ultrasound. After talking to women and their ultrasound techs we've concluded that the positioning is more awkward when the uterus is retroverted and this makes viewing a bit trickier. There may be a possibility that when the baby lies parallel to the ultrasound beam, measurments may be off and the baby will appear smaller than he actually is. However, in the second trimester, measurements are generally more accurate in women with a tilted utersus.
I'd like to wait to end my pregnancy but is it safe?
According to the 'Journal of Family Practice' and other medical organizations, a woman can safely wait to miscarry naturally (or until she knows for sure there is absolutely no hope) if she:
1) does not have a fever
2) has stable vital signs
3) has no excessive pain
4) has no excessive bleeding
If you meet these four criteria, waiting before having a D&C or to have a natural miscarriage is a reasonable option. If you do not meet these criteria, you could be at risk for infection. Seek help immediately.
Okay, I can safely wait, but how long will I have to wait?
We've seen women who were diagnosed with a blighted ovum who only had to wait a week or two before miscarrying or finding their babies and others who needed to wait three or more weeks. We do know with some certainty that waiting only one week, especially if you are eight weeks or less is not enough time to be certain you have a blighted ovum.
But, doctors would never misdiagnose something as important as a miscarriage, would they?
Unfortunately, the answer is yes and we can say that with reasonable certainty because we get several cases a month on the website where a woman was misdiagnosed. In many of these cases, the misdiagnosed woman has already turned down the D&C at least once.
How often do you think a blighted ovum is misdiagnosed?
Honestly, the vast majority of diagnosed miscarriages are in fact miscarriages. We do believe, though, that a fairly large number of women who are diagnosed with a blighted ovum AND have a retroverted uterus are misdiagnosed especially if they are diagnosed at eight weeks or before.
They finally found my baby at 10 weeks but are telling me I am only 7 or 8 weeks but I know this is impossible. How can this be?
The measurements taken by transvaginal ultrasound are very accurate during the first trimester and used by physicians to date the pregnancy. However, they are subject to human error and, we believe, they are not quite as accurate if your uterus is tilted. We've had a number of women who knew exactly when they conceived but did not see their babies until 8 to 12 weeks (or even more) and, when finally found, their doctors insisted their dates were off by weeks. Even if the woman only had sex one time, they'll insist she got pregnant weeks later. We believe that with the awkward positioning during the ultrasound coupled with the tilted uterus, dates are skewed during the first trimester. And, in fact, most of these women report the dates as being accurate again at their 20 week (or second trimester ) ultrasound.
Hey hun, it sounds to me like the pregnancy is growing and your levels are going up, granted its a bit strange to see that big of a jump but they are still going up, not down. unfortunately the doctor COULD be right, generally the HB shows up on vaginal ultrasound at around 6-6 and a half weeks, and the sac grows about 1.2mm a day, so again you had a big jump, which I have never heard of really but its not necessarily a bad thing. I would suggest another ultrasound in around a weeks time that way you will be sure what the pregnancy is doing before your doctor makes you have a D&C incase the pregnancy is viable and healthy. This is a tough one. as for the blighted ovum, I have never heard of a fetal pole growing when this happens?!?! thats not to say it doesn't happen, but I look for these things online ALOT!! and I have never heard of it. So in short, my advice is don't have the D&C until you find out for DEFINITE that the pregnancy has failed, your doctor could be wrong! anyways, good luck hun and I wish you all the best and I hope things go well for you :)
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