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still feel pregnant, even though no fetal heartbeat

  I had a positive pregnancy test and then went to the doctor because of some spotting.  At the time he detected a heartbeat that was slow, approximately 60 beats per minute.  10 days later, the heartbeat was still very slow, and there was not much growth.  He told me he suspected that I would miscarry.  Five days later the ultrasound detected no heartbeat, so he sent me home to let things naturally progress.  That was a week ago, and I still am having morning sickness, insatiable hunger, and the tiredness associated with pregnancy.  Could I have an infection?  Should I ask for a D&C, or are these feelings just related to stress?  Also, how long should it take from no heartbeat detection for the pregnancy to miscarry?  Thank you.
Dear Susannah:
Although the fetal heart has stopped, it takes days to weeks for the early placenta to recognize this, stop growing, turn off the hormones that cause the symptoms of early pregnancy ( nausea, fatigue) and thereby withdraw the hormonal support that keeps the uterus quiet.
There is no way to predict how long it will take for "natural progression". Valid reasons for a D&C include concern by the patient: discussion of this option with your physician is appropriate.
Keywords: miscarriage
This information is provided for education purposes and is not a medical consultation. If you have specific questions, please contact your physician.

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