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Twin pregnancy at 6 weeks no heartbeat
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by blondecdn, Dec 30, 2008
Hi, according to my radiologist I am expecting twins. One is 5 weeks and one is 6 weeks. Today at my second follow up ultrasound there were no heartbeats detected. The doctor has suggested that I schedule a D&C procedure and that I will most likely not miscarry on my own. However, after much reading up on the topic, I am hesitant to proceed with the D&C as many twin ultrasounds have not shown a heartbeat until the 7th week.

It also makes me uneasy that my doctor did not order any blood work to determine Pregnancy Hormone levels.

Other than some abdominal pain, I am not experiencing any signs of miscarriage. Should I hold off on the procedure? What is the typical timeline for a multiple pregnancy to show a heartbeat?

Thank you so much for your time. I appreciate your response.
Answer:
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by Elaine Brown, MDBlank, Dec 30, 2008
Hi!
Depending upon the technology, there should be a fetal heart rate by 6-7 weeks.

In my own practice, I almost always double check everything before doing a D&C.

I would check two quantitative beta HCG values 48 hours apart.  If the level is decreasing, the news is bad.  I will often wait a week and do another ultrasound too.
The only real down side to waiting, is the chance that you will miscarry spontaneously and have to go to the emergency room--most of my patients are willing to make that trade off for the peace of mind of knowing that there was no medical error.

I don't want to raise your hopes, but I'll cross my fingers that they are wrong!

Best!
Dr B
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Member Comments (5)
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by Lissyloo, Jan 01, 2009
they didnt find a heart beat at all with me at 5wks and i was bleeding they didnt think i had misscarried, they got me back at 6 and a bit wks and just picked up a heart beat, if u had a ultrasound in a wk i bet they would pick up a heart beat if all is well, dont let them do anything to u unless u have had the things done the doc above me is talking about

they did those with me and thats also how they knew i wasnt miscarrying
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by allymama, Jan 05, 2009
I am also going through somewhat of the same situation. I went to my first appt. thinking I was 13 weeks pregnant due to my last period. The doctor told me by feeling my stomach that I was no longer than 10 weeks along in the pregnancy. So she ordered an u/s the same day and during the external u/s they seen nothing no sack/fetus or heartbeat. They did an internal u/s same day, and seen two sacks but no heart beats. Me and my husband are ecstatic for twins, but so scared of the outcome that there are no heart beats at this point. The doctor did not even tell me how far along she thought I was after the heart beat. They ordered the pregnancy hormone 48 hour test to be done this week, and then they are going to do a second u/s a week from that appt. to see if there was any growth or heartbeats.

Good luck with everything!!
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by egude, Jan 06, 2009

Oh!  I am so surprised so see that you are experiencing the same thing as my self.

At 10 week when i did an external u/s , they saw no sac/fetus or heatbeat. But when they did an internal u/s, the saw a twin gestational sac with no heart beat. presently, the Doc placed me on homones injections. This weekend, i will go for another u/s.

Pease let me know of the progress of you situaton so that i can hint my doc. and equally be encouraged. My e.mail is ***@****. THANKS

I pray that  God should see us through to the Glory and praise of His Holy Name Amen!
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by PUZZLED777, Jan 13, 2009
I FOUND OUT I WAS PREGNANT ON A MONDAY AND BY FRIDAY I STARTED TO BLEED SPOTTING AT FIRST AND THEN A MAJOR BLEED WITH CLOTS AND MATTER I WAS TAKEN TO HOSPITAL BUT WAS SENT HOME AND TOLD TO COME BACK ON THE FOLLOWING MONDAY FOR A D/C.PRIOR TO DOING THIS PROCEDURE THEY GAVE ME A INTERNAL ULTRASOUND AND FOUND A HEARTBEAT,I WENT ON TO HAVING A HEALTHY BABY BOY.MY QUESTION IS WAS I PREGNANT WITH FATERNAL TWINS THE DOCTORS DIDNT GIVE ME AN ANSWER.