ObGyn/Pregnancy issues/Viability

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Question
I am 7.5 weeks pregnant.  I had some pretty strong cramping at 6.5 weeks so I went for an ultrasound to make sure the pregnancy was in the uterus.  It was but they saw a gestational sac and a yolk sac and it measured 4.5 weeks (2 weeks behind).  I went for a follow-up scan yesterday (7.5 weeks) and they were able to identify a baby and it measures 6.5 weeks but there is not a heartbeat.  In another image, the yolk take up much of the space and the images look 'disorganized' and not very clear anymore.  

The doctor says that the pregnancy is not viable.  She offered to give me medication to induce the miscarriage now but I chose to wait and see what happens.  I am going back next week for another scan.  

I have two questions. 1) If the pregnancy appears to be progressing (there was growth equivalent to 2 weeks in just 1 week), is that an indication that there is still hope?  Or does that happen often in non-viable pregnancies?  2) If it is not a viable pregnancy, is it okay to just wait and let my body handle it in it's own time rather than taking medication or having a D&C?

Answer
Ash
At 7 weeks pregnancy, we are not very much concerned about how growth occurs especially because what is called inter and intra-observer variability.i.e. sonographic measurements may vary if carried out by different personnel or different machines at 2 different times as in 2 successive weeks. We are mainly concerned about heart beats at 7 weeks. If not present,we usually allow 1 week and rescan. If no beats are seen, then the pregnancy is considered non viable.
The body cannot gets rid of a dead fetus on its own. Medications help the body to evacuate the uterus. This is followed by ultrasound examination to confirm that the uterus is empty. if not, however, D & C may become necessary.

Good Luck

ObGyn/Pregnancy issues

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Volunteer


Mohamed Kandeel

Expertise

I can answer questions about antenatal care, medical problems associated with pregnancy, labor and delivery and postpartum care.

Experience

Currently I am working as a Professor of Obstetrics gynecology, Menofyia University, Egypt. Since 1987, I worked in many university and private hospitals with a high load of pregnant population averaging 7-9,000 deliveries/year. This exposed me to all problems associated with pregnancy, labor and delivery. I had my doctorate degree in Obstetrics and Gynecology in 1996 in the use of Doppler ultrasound in high risk pregnancies.

Organizations
Menofyia University, Egypt

Publications
-British Journal of Obstetrics and Gynecology (Kandil M) -Egyptian Journal of Obstetrics and Gynecology (Kandil M) -Ain Shams Journal of Medicine (Kandil M)

Education/Credentials
-Master's degree in obstetrics and Gynecology 1989 -Doctorate degree in Obstetrics and Gynecology 1996

Awards and Honors
Editorial advisor: Fetal monitoring section of the international website www.obgyn.net

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