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What Does My Ultrasound Report Indicate?

Posted on Tue, 29 Apr 2014

Question: my last period was 12 feb i asked u before about my sac last week my by abdominal u/s shows 9 mm sac by abdominal a week later my vaginal u/s show 10 mm sac + yolk sac ( my dr said we cant compare abdominal measures to vaginal ) , he was positive that 10 mm sac contain yolk sac , he said i am 5-6 weeks , but according to my lmp i should be 7 weeks any way my hcg still rising i uploaded my new vaginal u/s please give me ur openion , i notice yolk sac and white dot what is that dot

Answered by Dr. Madhuri N Bagde (37 minutes later)

Brief Answer: Detailed report provided Detailed Answer: hello and welcome, I am Dr Madhuri and will be helping you. I understand that the ultrasound done a week ago showed a 9 mm sac while the current one shows a 10 mm sac plus a yolk sac that was not seen in the initial scan. Also there is a rising HCG. I have seen the scan, it shows a sac with a yolk sac and the dot may be the fetal pole. As of now, the possibility may be : 1. delayed conception: meaning the ovulation occurred later than the expected date and hence the baby is a bit smaller. 2. missed abortion: as the difference in both reports in terms of measurements is not substantial. A 1-2 mm difference in a week may simply be an instrument error. However the other findings like presence of yolk sac and rising HCG do not favor this. The only exception is that sometimes HCG may continue to rise for some days after abortion until placental tissue is functioning. My suggestion to you is to please take thing a bit slowly as everything needs time. The baby also needs time to grow and so we must allow a time span of at least 2 weeks between scans to detect substantial growth. I do understand your concern and share it. Please continue to have patience and there will be a reward. Also do not stress as it is not good for the baby. The baby will be fine if the mother is fine. Having said this I request you to repeat the scan after 2 weeks. By that time the parameters must show 7-8 weeks and a fetal heart must be visible. If this is there, it is just delayed conception and nothing else needs to be done. If it still shows 9-10 mm and 5-6 weeks or you have bleeding in the intervening period, it is missed abortion. Meanwhile ask your doctor for drugs to help sustain pregnancy like duphaston and HCG injections. Their deficiency in early pregnancy may cause abortions and supplement helps in a few cases. So there is no harm in trying our best. Also continue to take folic acid to prevent brain defects in the baby. Do not do heavy work. Rest as much as you can and all these help the pregnancy. You will be fine with all these measures. Hope this satisfies your query. Thanks for using HCM and my good wishes are with you for a positive report. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Madhuri N Bagde (21 minutes later)

thanks alot , 1/ my dr said my first measurement was by abdominal 9 mm , this measurement by vaginal 10 mm , he said we cant compare those 2 measures , as he said for abdominal yolk sac appear when gestational sac above 16 mm , but in vaginal yolk sac appear in sac 8-11 mm , also , that one was really tiny , first one measured 4 weeks 5 days , but this one a week later measure about 5 weeks 4 days , so said this is normal develpment , is that true ?? , yes i am taking anticlotting inj + baby asperin + vaginal progesterone ? as u see the sonar , is this normal ? do you think this dot is fetal pole or yolk sac ?

Answered by Dr. Madhuri N Bagde (6 hours later)

Brief Answer: It may be a viable pregnancy. Detailed Answer: Hello and welcome, I saw the new image. Unfortunately the older one is lost and I am able to see only the new one and both are same. Anyways, there appears to be growth in the baby in the latest scan as compared to the first scan. But having said this, the images are not comparable, the parameters are comparable. This is because the images may have been taken from different angles, different probes and different distance. So as our vision has something called perspective where things appear big when close and small when far, this may be the same thing. However the new scan does show more tissue as compared to the first. The dot may be a fetal pole. It is usually seen on the margin of the yolk sac around 6 weeks. You are receiving the correct treatment. Folic acid is not mentioned in the drugs. Please check to see if you are taking it. If not, start it as it helps in preventing brain defects in the baby. Even now you appear to be in a bit of stress. Please calm down. You are concerned which is good as this ensures you will follow the treatment and be vigilant. But do not be stressed. Just continue the drugs and rest and repeat the scan after 2 weeks. It is too early days for us to make too much out of the scans. The good news is that the sac still has a regular margin and it appears to have grown and also the HCG is rising. You have already done everything possible at this stage and congratulations for that. I am here to help all the time and please feel free to ask any more queries that you may have. Take care and all the best. Dr Madhuri Bagde [If you upload the images again, please upload all of them simultaneously as the system on my side shows only the latest ones and older ones are not displayed.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Madhuri N Bagde (8 hours later)

i uploaded both images together , yes i am taking methylfolate , my hcg since i did first abdominal u/s until i did vaginal ( week apart ) had been risen around ( 4 times )

Answered by Dr. Madhuri N Bagde (30 minutes later)

Brief Answer: Favors a viable pregnancy Detailed Answer: hello and thanks for the images, I have seen both the images together. There is a presence of yolk sac in the second and the rising HCG favors a viable pregnancy. The yellow dot may be a fetal pole or an artefact it is too early to say definitely. So please continue the treatment and take rest. Repeat the scan after 2 weeks to be 100% sure. All my good wishes are with you. I am always here to help you if there are any further queries feel free to ask. Dr Madhuri

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Madhuri N Bagde (2 days later)

thanks alot dr my dr request my last hcg was 19900 then 41200 after 4 days , he told me this is good doubling as hcg over 6000 doubling time over 96 hrs , now i am waiting my appt for ultrasound , i hope to see heartbeats

Answered by Dr. Madhuri N Bagde (6 hours later)

Brief Answer: congratulations! Detailed Answer: Hello and welcome back, I am very positive that heart beat will be seen considering the HCG levels. I suggest that you do not hurry for the scan as it might again show a negative result if taken too early. Wait at least for a week after the 5-6 weeks scan for results and better still if it is done after 1 1/2 - 2 weeks for best results. If it is repeated too early and heart beat is not seen if the scan was too early to pick it up, you will again be in stress. Please continue your treatment as this is the most that we can do now and the baby is responding. I do understand your anxiety, but remember that patience pays. All my good wishes are with you. I am very happy to know the HCG reports. Warm Regards, Dr Madhuri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Madhuri N Bagde (2 days later)

Thanks dr Today was my scan , we see fetus or fetal pole i dont know difference , and heartbeat , accordind to CRL i am 7 weeks 2 days

Answered by Dr. Madhuri N Bagde (3 hours later)

Brief Answer: Congratulations!! Detailed Answer: Hello and welcome back. Congratulations. I am so happy for you. It means that the baby is doing well. Just remember the dates of this scan as well as the expected date of delivery as suggested by this scan. Continue your old treatment of aspirin etc and don't exert yourself. There is no need to do repeated scans now. The next may be done at 12 weeks. I am always here to answer any further queries. Congratulations once again and take care. Dr Madhuri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar