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.
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!
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.
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