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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will The Pregnancy Progress Normally After No Heartbeat Shown?

Hi, my wife's first ultrasound at 6w 6d showed a gestational sac, yolk sac and embryo measuring 2.3mm dated at 5w, and no heartbeat. We did a repeat scan at 8 weeks (2 days ago) which revealed a growing gestational sac and yolk sac measuring 8w, but no sign of an embryo or a heartbeat. The second ultrasound was performed at another center and, to my untrained eye, the images do not seem as clear as our first scans.

What is the likelihood that this pregnancy will progress normally?

If it will not progress, what criteria should we consider to choose between waiting for a normal miscarriage, or to opt for a medically induced miscarriage (drugs or D&C)?
Mon, 12 Jan 2015
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OBGYN,  's  Response
Hello,
Heart beat should usually be observed by 6 weeks and later by 7-8 weeks in a trans-vaginal ultrasonogram. If no heart beat is observed as in the case of your wife, a follow up sonogram should be done preferably using the same machine and sonologist and this may be associated with estimation of serial serum beta-hCG titres which show doubling titres every 2-3 days if the pregnancy is progressing well. I would suggest a repeat trans-vaginal sonogram at the same place where the first was taken and if that is not possible, at least, go for a second sonogram elsewhere. If heart beat is not seen, and there is no increase in the size of the sac, it would be wiser to consider evacuation as the pregnancy is likely to have stopped growing. Hope this helps.
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Will The Pregnancy Progress Normally After No Heartbeat Shown?

Hello, Heart beat should usually be observed by 6 weeks and later by 7-8 weeks in a trans-vaginal ultrasonogram. If no heart beat is observed as in the case of your wife, a follow up sonogram should be done preferably using the same machine and sonologist and this may be associated with estimation of serial serum beta-hCG titres which show doubling titres every 2-3 days if the pregnancy is progressing well. I would suggest a repeat trans-vaginal sonogram at the same place where the first was taken and if that is not possible, at least, go for a second sonogram elsewhere. If heart beat is not seen, and there is no increase in the size of the sac, it would be wiser to consider evacuation as the pregnancy is likely to have stopped growing. Hope this helps.