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What Does The Following Ultrasound Report Indicate?
Question: Hi Doctor, this is my ultrasound at 7 weeks 6 days. Everything looks good but I'm a bit concern with my Yolk sac size being 5mm at the moment. I heard the normal Yolk sac size should not be more than 6mm and it will graduatelly grow in the size until 10 weeks. I'm a little worry if by 10 week it will exceed 6mm? I have very limited knowledge on this and would like some explanation on this and knowing if my size is right for my pregnancy week. My last period started 20/08/2016. Thank you!
Brief Answer:
A yolk sac diameter of 5mm is completely normal at this gestational age
Detailed Answer:
Hello, and I hope I can help you today.
First of all I want to reassure you that all the findings on the ultrasound report you submitted are completely normal.
The yolk sac is literally the remains of the yolk that nourishes the fetus in the earliest part of pregnancy before the placenta develops, just like the yolk of a chicken egg. As the fetus grows, it consumes the yolk and then the sac gradually disappears. The diameter of the yolk sac actually decreases as the fetus gets bigger because the yolk is consumed.
The actual size of the yolk sac is really not relevant in the context of a normal pregnancy with a heartbeat. There is a range of sizes for the yolk sac, but up to 8mm has been described in normal pregnancies. A small, irregular or absent yolk sac can indicate a possible miscarriage if a fetus is not seen on an early ultrasound, but the fact that your fetus has a heartbeat, and measures within 5 days of the size expected by the first day of your last period, shows that at the time of this ultrasound, your fetus was healthy and viable.
So in summary, the diameter of the yolk sac in your pregnancy is completely normal. The size of the yolk sac in general is not really relevant to pregnancy outcome, so there is no reason to worry as the fact that the fetus has a heartbeat is the most reassuring sign that everything is normal.
I hope I was able to adequately answer your question today and that my advice was helpful. If you need any further information, please do not hesitate to contact me.
Best wishes,
Dr. Brown
A yolk sac diameter of 5mm is completely normal at this gestational age
Detailed Answer:
Hello, and I hope I can help you today.
First of all I want to reassure you that all the findings on the ultrasound report you submitted are completely normal.
The yolk sac is literally the remains of the yolk that nourishes the fetus in the earliest part of pregnancy before the placenta develops, just like the yolk of a chicken egg. As the fetus grows, it consumes the yolk and then the sac gradually disappears. The diameter of the yolk sac actually decreases as the fetus gets bigger because the yolk is consumed.
The actual size of the yolk sac is really not relevant in the context of a normal pregnancy with a heartbeat. There is a range of sizes for the yolk sac, but up to 8mm has been described in normal pregnancies. A small, irregular or absent yolk sac can indicate a possible miscarriage if a fetus is not seen on an early ultrasound, but the fact that your fetus has a heartbeat, and measures within 5 days of the size expected by the first day of your last period, shows that at the time of this ultrasound, your fetus was healthy and viable.
So in summary, the diameter of the yolk sac in your pregnancy is completely normal. The size of the yolk sac in general is not really relevant to pregnancy outcome, so there is no reason to worry as the fact that the fetus has a heartbeat is the most reassuring sign that everything is normal.
I hope I was able to adequately answer your question today and that my advice was helpful. If you need any further information, please do not hesitate to contact me.
Best wishes,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you Dr Brown. I have one more question. From day 14, my doctor issued me a drug called prednisone 5mg daily to prevent natural killer cells that stop embryo to implant. She did advice that I can stop use it by week 6 but did not instruct me how. I have gather some information from the forum that many woman use it for the whole first trimaster and slowly tapper off. My doctor has moved away from the city and I will not see the nex O/B until week 10. I have started to reduce my dose without further consult from 5mg daily to every second day from 6 weeks 5 days until now. Just wondering (1). Is it safe to stop the prednisone this early given some others took it for the first 12 month? (2). What is the reason to tapper off instead of stop instantly? Consider i'm already in low dose can i just completely stop it now? (3). I heard there could be side effect of prednisone in the first trimaster or harm the baby if taking long term, given the dosage of how much i took in the past 6 weeks, should i be concern about those side effect and bad impact on the baby's development? I feel a bit struggle to go either way. Either stop too early and make the natural killer cells active again, or stop too slow or too late that also potentially harm the baby. Thank you!
Brief Answer:
Prednisone is completely safe in all trimesters of pregnancy
Detailed Answer:
Hello again,
Prednisone, as well as other medications in its class, called corticosteroids, are used safely during pregnancy to treat a number of conditions. Prednisone is used to treat autoimmune diseases such as lupus during pregnancy or even asthma as well as infertility treatment without any long term effects on the baby. Doses for autoimmune diseases can be even as high as 60mg daily during the whole pregnancy. The role of steroids in fertility treatment is controversial and there is no one regimen that is routinely prescribed for everyone,
It is recommended to taper steroids (meaning gradually reducing the dose before stopping it) when a person is on them for a long period of time or on a high dose to prevent a sort-of withdrawal syndrome but this is only necessary when on a much higher dose than you were taking. Typically, if you were on more than 60 mg of prednisone daily, doctors would have you gradually reduce the dose by half over a period of a few days. However, on a 5mg daily dose, just stopping the mediation without a taper will not cause any ill effects on you or the fetus.
So if your did not receive specific instructions otherwise, I advise you just to finish the medication you have and once your supply runs out, you do not need to take it anymore. If your doctor said you do not need it after 6 weeks gestation, and you are already 7 weeks, the mediation has done its job and you cab safely stop it. As you mentioned, the drug was given to you to enhance implantation, and if you already are 7 weeks implantation has already taken place and was successful.
I hope this additional information was reassuring and I wish you the best of luck for the rest of your pregnancy!
Regards,
Dr. Brown
Prednisone is completely safe in all trimesters of pregnancy
Detailed Answer:
Hello again,
Prednisone, as well as other medications in its class, called corticosteroids, are used safely during pregnancy to treat a number of conditions. Prednisone is used to treat autoimmune diseases such as lupus during pregnancy or even asthma as well as infertility treatment without any long term effects on the baby. Doses for autoimmune diseases can be even as high as 60mg daily during the whole pregnancy. The role of steroids in fertility treatment is controversial and there is no one regimen that is routinely prescribed for everyone,
It is recommended to taper steroids (meaning gradually reducing the dose before stopping it) when a person is on them for a long period of time or on a high dose to prevent a sort-of withdrawal syndrome but this is only necessary when on a much higher dose than you were taking. Typically, if you were on more than 60 mg of prednisone daily, doctors would have you gradually reduce the dose by half over a period of a few days. However, on a 5mg daily dose, just stopping the mediation without a taper will not cause any ill effects on you or the fetus.
So if your did not receive specific instructions otherwise, I advise you just to finish the medication you have and once your supply runs out, you do not need to take it anymore. If your doctor said you do not need it after 6 weeks gestation, and you are already 7 weeks, the mediation has done its job and you cab safely stop it. As you mentioned, the drug was given to you to enhance implantation, and if you already are 7 weeks implantation has already taken place and was successful.
I hope this additional information was reassuring and I wish you the best of luck for the rest of your pregnancy!
Regards,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thanks Dr Brown. My doctor was using the prednisone for the natural killer cells detected within the uterus. I had an ectopic pregnancy previously and done a laproscopy surgery and that was what they found from the surgery last time. So i was on low dose of prednisone and asprine. The doctor did mention to stop it at 6 weeks but asprine can continuing until later. I was worry if i stop prednisone and the natural killer cells become active again and started to attack the embryo. I know that the doctor did explain that natural killer cells were only an issue for implantation. Just want to get a second opnion on this from you as well in relation to the role of the natural killer cells in pregnancy. Thank you.
Brief Answer:
There is no medical evidence that NK cells have a role in pregnancy
Detailed Answer:
Hello again,
As I mentioned previously, the role of natural killer cells in pregnancy outcome is controversial at best.
In the medical literature, the main role that reproductive immunology has is within the context of pregnancies conceived with in-vitro fertilization. It is theorized that in patients with a history of unsuccessful IVF treatment that inflammation may play a role, however there is no medical evidence that treatment with steroids or other anti-inflammatory medications (such as aspirin) actually increase success rates of IVF. refer you to the following article for reference: http://www.hfea.gov.uk/fertility-treatment-options-reproductive-immunology.html
So in a normal pregnancy not conceived via IVF there is no evidence that taking prednisone helps having a successful pregnancy, even with implantation. And in IVF pregnancies, treatment with steroids to reduce NK cell activity is completely theoretical. So I really do not think you need to worry about stopping the prednisone, as there is no concrete medical evidence that it has any effect on the pregnancy to begin with, and you already have a live fetus with a heartbeat.
The best thing you can do at this point to ensure the health of your pregnancy is to eat a well-balanced diet, get enough rest, and take prenatal vitamins daily.
Take care,
Dr. Brown
There is no medical evidence that NK cells have a role in pregnancy
Detailed Answer:
Hello again,
As I mentioned previously, the role of natural killer cells in pregnancy outcome is controversial at best.
In the medical literature, the main role that reproductive immunology has is within the context of pregnancies conceived with in-vitro fertilization. It is theorized that in patients with a history of unsuccessful IVF treatment that inflammation may play a role, however there is no medical evidence that treatment with steroids or other anti-inflammatory medications (such as aspirin) actually increase success rates of IVF. refer you to the following article for reference: http://www.hfea.gov.uk/fertility-treatment-options-reproductive-immunology.html
So in a normal pregnancy not conceived via IVF there is no evidence that taking prednisone helps having a successful pregnancy, even with implantation. And in IVF pregnancies, treatment with steroids to reduce NK cell activity is completely theoretical. So I really do not think you need to worry about stopping the prednisone, as there is no concrete medical evidence that it has any effect on the pregnancy to begin with, and you already have a live fetus with a heartbeat.
The best thing you can do at this point to ensure the health of your pregnancy is to eat a well-balanced diet, get enough rest, and take prenatal vitamins daily.
Take care,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thank you Doctor Brown. I shall stop it straight away. Thank you for the information provided.
Brief Answer:
You are very welcome
Detailed Answer:
Again, congratulations on your pregnancy and I wish you the best of health!
If you have concluded your query, kindly close the question and if you are satisfied with my services, please post a rating accordingly.
Thanks again for using healthcaremagic.com and my services,
Dr. Brown
You are very welcome
Detailed Answer:
Again, congratulations on your pregnancy and I wish you the best of health!
If you have concluded your query, kindly close the question and if you are satisfied with my services, please post a rating accordingly.
Thanks again for using healthcaremagic.com and my services,
Dr. Brown
Above answer was peer-reviewed by :
Dr. Yogesh D
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