Question: Dear Doctor, Today we went for Ultrasound for early pregnancy of my wife. Below are the reports: 1. Single Intrauterine gestational sac is seen containing well defined yolk sac. 2. Gestational age by GSD(7.4 mm) is 5 weeks 3 days . EDD by USG : 21/09/14 3. Decidual reaction is normal in thickness and echogenicity 4. No subchroinic bleed is seen. 5. Fibroid measuring approximate 18 x 14 mm is seen in anterior myometrium. 6. Internal os is closed 7. Cervical length is normal. 8. Corpusluteal cyst measuring approx 20 x 17 mm is seen left ovary. Advice : follow up scan for cardiac activity. Kindly advise regarding above report

Dear Doctor, Thanks for your reply. Earlier there was a miscarriage on 13th October'13. Now using Susten-200 mg vaginally, Ecospirin -75 and Folivate(Folic Acid) as per prescription by my good Doctor. Certain Tests below were carried out to ascertain the reason of previous miscarriage (Test carried out on 22th November'13) as per below: COAGULATION: ACT PARTIAL THROMBO PLASTIN TIME (APTT), PLASMA APTT- 29.80 REFERENCE RANGE - 25.00 - 34.70 SECONDS APTT CONTROL - 27.3 RANGE 24-38 APTT(TEST + CONTROL) 1:1 - 12.7 SECONDS BIO CHEMISTRY: GLUCOSE FASTING, PLASMA/URINE - 94 GLUCOSE POST PRANDIAL, PLASMA URINE - 102 SEROLOGY: VDRL - NON REACTIVE EIA AUTO IMMUNE: ANTI CARDIOLIPIN ANTIBODIES IGM- 0.34 Negative : Less than or equal to 15 ANTI CARDIOLIPIN ANTIBODIES IGG- 0.96 Negative: Less than or equal to 15 These tests were carried out and reported normal. Any Impact of previous miscarriage , what should we do to avoid?

Dear Doctor, Thanks for your reply. Today went to my Doctor for showing the ultrasound report ( as mentioned above). She has advised fertigyne-5000 i u injection once a week and duphastone( twice a day) along with earlier medicines (ecospirin, sustene-200, folivate) and advised further ultrasound after 2-3 week. Hope everything be good. Regards

Thank You very much Doctor. Regards

Dear Doctor, Refer my earlier correspondence, we went for follow up ultrasound (TVS) on 04.02.2014. The report is as follows: 1) Single Intrauterine gestational sac is seen containing well defined yolk sac. 2) Gestational age by CRL(2.4 mm) is 5 weeks 6 days. 3) Gestational age by GSD(10.3 mm) is 5 weeks 5 days. 4) Gestational age by LMP(05.12.13) is 8 weeks 5 days. 5) Embryonic cardiac activity is absent. 6) Decidual reaction is normal in thickness and echogenicity 7) No subchroinic bleed is seen. 8) Internal os is closed 9) Cervical length is adequate. 10) Both ovaries are normal in size and echotexture. No associated adnexal mass is seen. Impression: Findings are suggestive of missed abortion. We find it difficult to reconcile with above report as the symptoms are there with no pain/bleeding etc. So we decide for other ultrasound scan(TVS) at different place. Findings are as follows: 1) Foetal Number & Viability : Single Intrauterine G.Sac 2) Foetal Node + 3) Foetal Head – 4) Cardiac Activity – Not visualised 5) Placenta – 6) Internal OS Closed 7) Internal Haemorrhage – 8) Yolk Sac- Normal 9) L Cyst- Not well visualised 10) MGA weeks 11) G Sac 16 mm ( 6 Weeks 0 days) 12) CRL 2.3 mm( 5 Weeks 5 days) 13) Any other : 15 mm intrauterine fibroid in anterior myometrium. Impression: 6 weeks intrauterine pregnancy without cardiac activity .Suggest follow up USG after one week for cardiac activity. We did both above scans on 04/02/2014. I want to add few more details: LMP -05/12/13 Urine Test in Hospital on 09/01/14- Indeterminate Beta HCG level on 09/01/14 – 123 Beta HCG level on 11/01/14-312(more than double in 48 hrs) Are these sign of delayed conception or something else? Kindly see.

Dear Doctor, LMP-05/12/13 and pregnancy was established on 11/01/14 by doubling Beta HCG levels.Even on Urine Test it was indeterminate.How many weeks pregnancy should be at that time? I am having all pregnancy related symptoms and no abnormality in health. If fetus isn't growing since 2 weeks,i assume it should have been evacuated naturally till now. I am having positive feelings. Regards