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7w5d meausring 5w6d with HR of 93
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7w5d meausring 5w6d with HR of 93

Hi Dr. Brown,
I am pregnant with my second child which was planned through a trial of clomid due to not menstruating while working night shift as a nurse.  Since this time, I have found a new job with normal hours, THANK GOD!  Anyways, I went for a second US today and am very upset.  I went for my first at 6w1d and a gestational and yolk sac were found, but no fetal pole or heartbeat yet.  I also measured 4 days begin, at 5w4d.  I went for repeat US today and there was a fetal pole and heart beat, but the HR was only 93.  The fetus measured at 5w6d when I should be 7w5d today.  The yolk sac was also larger than the fetus.  My MD was not in that day, so I was only able to speak with the tech that did my US.  I go for a repeat US in a week and feel like this is agony, playing a waiting game again.  I just want to know what my odds are in all of this that this will carry on to be a normal pregnancy.  I am optimistic because there is a fetal pole and heart beat which is a change from my first US.  However, I feel like there are so many odds against me with the findings.  Being a nurse makes it even worse because I know all of the things that can go wrong.  Any advice you have whether good or bad would be greatly appreciated to give me some peace and clarification.
Tags: 93, HR, ultrasound, fetus
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If you go online and look at the data, a low fetal heart rate is supposed to be a poor prognostic indicator.  HOWEVER in my own experience, when the heart rate is detected very early on (before 7 weeks) it is very frequently in the 90's.
I have seen numerous pregnancies with happy endings that began with a low heart rate.
If the heart rate jumps up into the high 150-170 range with your NEXT ultrasound that will be an excellent sign.  The ultrasound is really going to give you the data that you need.
A couple of things to consider--you could do serial quantitative HCGs to see if they are rising rapidly--this is really overkill, but is a sign of a healthy pregnancy.
You could also do a progesterone level--a level above 15 is a good sign too--again is probably over kill.

I wish you all the best--sometimes I think we were better off before the super sensitive pregnancy tests!
Dr B
I am very early in my second pregnancy.  The first one was a missed miscarriage discovered at 9 weeks, 3 days.  I had one period then got pregnant again.  My period between this pregnancy and my D&C began unusually, so I am estimated my LMP.  It puts me at 5 weeks, 5 days today.  My doctor had me go for bloodwork last week.  My hCG was good, but my progesterone was low.  On week 4 day 4 it was 8.8.  On week 4 day 6 it was 9.5.  

Is 9.5 really low at this stage of pregnancy?  My doctor put me on a progesterone supplement (Cronine 8%).  Also, does it make a difference that I tested in the late afternoon (after lunch) and was under a lot of stress at the time (both days)?  I am going for a high tech ultrasound tomorrow for dating and viability and hoping for the best.

Thank you for any insight you can give me.  
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