Scanned And Report Showed No Foetal Cardiac Activity. Prescribed For Missed Abortion. Should I Take Medicine Or Wait?

Posted on Fri, 31 May 2013

Question: hi , I am today scanned and my report are; the yolk sac and fetal pole are identified, however no fetal cardiac activity noted.CRL=25MM(9w1d) . doctor has prescribed for missed abortion and to take medicine.My LMP is 04/03/12.Plz advised what to do either i take the medicine or wait for a week and again scan

Answered by Dr. Dr. ARIF N K (30 minutes later)

Hello XXXXXX
Thanks for the query. Ideally we should see heart beat by around 6 weeks, as yours Crown rump length is already 9 weeks plus and no fetal cardiac activity, sorry to confirm the diagnosis of Missed abortion. There is no use in repeating the scan, because its impossible for the appearance of cardiac activity now. I would have suggested you a repeat scan if it was in early gestation not at 9 weeks. I strongly suggest you to go ahead with Medical abortion as prescribed by your OBGY specialist. If that fails please be prepared for surgical evacuation as well.
The incidence of missed abortion among spontaneous miscarriages is 2.6-9.4%. A missed abortion is a non-viable pregnancy that is destined to miscarry, if there is a fetus it has no heart beat. Ultrasound criteria that strongly suggest missed abortion are sac diameter greater than 16 mm without cardiac activity or fetal pole greater than 4 mm without cardiac activity.

Hope I answered your question, Kindly reply me if you have any further queries or any comments. I will be very happy to help you.
Sincerely,
Dr Arif N Khan
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Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Dr. ARIF N K (34 minutes later)

earlier already three scan have been done at interval of a week every time they told us no fp and gs but today how he got the fp and gs. is there any problem in further pregancies, at what interval we we try next. Is there any harm to for next 2 to 3 days and again do scanning

Answered by Dr. Dr. ARIF N K (17 minutes later)

HiXXXXXX
Thank you for the followup query.
1) When compared to previous scans, there could be an abnormal growth of the fetus. And common cause is genetic abnormalities like Aneuploidies/ chromosomal abnormalities. Hence its natures way of eliminating abnormal fetuses.
2)There is absolutely no problem with your future pregnancies, have faith in god. And you can try for next pregnancy after 6 weeks when you feel totally normal.
3)There is no harm in repeating the scan. But I feel its waste of money.

Hope I answered your question, Kindly reply me if you have any further queries or any comments. I will be very happy to help you.
Sincerely,
Dr Arif N Khan

Above answer was peer-reviewed by : Dr. Mohammed Kappan

Follow up: Dr. Dr. ARIF N K (41 hours later)

Sir, doc advised me to take mifepriston tab early in the morning in empty stomach and after 36hrs take one misoprostol(200mg) and put another one into the vagina and after 2hrs take two more misoprostol and watch for bleeding and piceces . plz advise what are the effects after taking this medicine and whats is to watch or when should i consult doc

Answered by Dr. Dr. ARIF N K (1 hour later)

Hello XXXXXX
Thank you for the question.

Mifepristone is a progesterone antagonist and its a anti pregnancy tablet and Misoprostol is prostaglandin. You can expect some amount of bleeding after last dose of Misoprostol. You should contact your doctor if bleeding is severe or if you get fever, foul smelling vaginal discharge, or severe pain abdomen. You can expect mild side effects like pain in abdomen at the time of abortion, slight bleeding. Kindly get a repeat scan pelvis after 15 days. If there is incomplete abortion you might require a surgical evacuation.

Hope I answered your question, Kindly reply me if you have any further queries or any comments. I will be very happy to help you.
Sincerely,
Dr Arif N Khan
Contact me directly at:
WWW.WWWW.WW

Above answer was peer-reviewed by : Dr. Vaishalee Punj