Expert: Catherine Beier MS CBE - 9/18/2011

Question
Hi, I was hoping you could shed a little light on my situation. My LMP was on 7/11 and I took a positive preg test on 8/13. My cycles are very regular 30-32 days. I went for my 1st doc appointment on 9/15 when I was 9wks 3days. When the doctor did the ultrasound she saw the sac but no baby. She sent me for an internal ultrasound right away. After a lot of looking the technician found a fetal pole measuring 6wks with a heart beat on the low side of normal 100bpm. She gave my doc this info and the doc says I must have my dates off. I told her I am very sure about the dates so what could that mean? She said then that could be concerning. I'm scheduled for a follow up on 9/23 a week after the 1st to check the growth. I don't understand any of this, she didn't tell me what it could mean or what the concerns might be. Also I have felt so pregnant from the begining I'm exhausted super emotional my breast are huge and already putting on weight.

Answer
Hello Danae,

Your doctor is concerned because given the dates you provided, the degree of pregnancy development that is expected wasn't present. Now, this can be completely normal - it's just too soon to tell at this point for a few reasons, one being that you could have conceived very late in your cycle, explaining the limited development level seen at present.

Typically, when a woman is 9 weeks pregnant, the baby is clearly visible with a strong heartbeat.  The fact that only a fetal pole was seen when the fetus should have been present typically suggests that either the dates were off or that there may be concerns with the pregnancy not developing correctly, which could be due to a variety of reasons.

At this point, it's too soon to tell anything - even with extremely regular periods, it's possible that you ovulated late in your cycle with a short luteal phase, meaning that you actually should only have been 6 weeks ago at the time of the ultrasound.

Once the follow up scan has been completed, the doctor will be able to assess whether the pregnancy is continuing to develop as expected or if anything seems to be amiss.

The fact that you're having pregnancy symptoms is a good one.  There's nothing to be gained by being stressed or worried at this time as 1) it will change nothing and 2) stress isn't good for you or the baby.  I realize though that's easier said than done. Try to focus on taking care of yourself, getting plenty of rest and good nutrition and you'll know more after the next scan.



Best,
Catherine