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Does The Pregnancy Continue If There Is No Visible Sac At 6 Weeks?
Question: Hi my age is 28 years old and my first delivery case was sigerian ( some 5 years back). This time around the urine test through the home kit showed a strong positive after four weeks of pregnancy. The doctor suggested an ultrasound at six weeks pregnancy. But there was NO featus detected in the ultrasound. Even an XXXXXXX ultrasound showed no featus. We did a urine home kit test again yesterday and this time its a weak positive. Is there any chance to continue pregnancy ( if any) if there is no sac visible even after six weeks? Should I also try doing a blood test for confirmation?
Also doctor I forgot to write something. After the urine test was a strong positive at four weeks pregnancy, there was very little spotting later. My gynae advised that this is normal as there was no major bleeding. I have had a couple of irregular cycles for the last few months, but this time around its almost 48 days that I don't have a period. In the last couple of weeks there have been strong pregnancy symptoms like nausea, heaviness and breast pain. But still there is featal sign after an ultrasound conducted at six weeks pregnancy. Also the urine test now is a very faint positive. One line is dark red and the second line is very lightish pink. What do u suggest I should do now?
Hi,
Thanks for your query.
Its clear that you have missed your periods and are about 6 weeks due.
Well, the urine pregnancy tests are fairly sensitive after 4 weeks. If its positive, is likely that you have conceived.
Now, the issue is that the scan is not showing anything.
There are few possibilities.
1. You might have conceived but when there was a bleeding, it could have been a early abortion.
2. You might have conceived, but the pregnancy can be elsewhere other than in Ovary. This is called Ectopic Pregnancy. In such cases, fetal sac is seen a little later than usual.
3. Or, its likely that its very early now and in next 1 - 2 weeks, the sac may develop in the uterus.
Transabdominal ultrasound cannot reliably diagnose pregnancies that are less than 6 weeks gestation. Transvaginal ultrasound, by contrast, can detect pregnancies earlier, at approximately 4 ½ to 5 weeks gestation.
So if at 6 weeks, the transvaginal USG has not picked up a fetal sac, you must take the following steps.
1. Get a beta - HCG test. Its a blood test and 100 % confirmatory for pregnancy. People who have doubts with urinary dipstick tests are advised this test.
2. Repeat a Transvaginal USG scan after 1 week for reconfirmation. Also to look for possibility of ectopic pregnancy.
With these two steps, you can be sure about the pregnancy and its site.
Hope this answers your query.
Please get back if you need any further information.
Thanks and Regards
Dr Kiran
Thanks for your query.
Its clear that you have missed your periods and are about 6 weeks due.
Well, the urine pregnancy tests are fairly sensitive after 4 weeks. If its positive, is likely that you have conceived.
Now, the issue is that the scan is not showing anything.
There are few possibilities.
1. You might have conceived but when there was a bleeding, it could have been a early abortion.
2. You might have conceived, but the pregnancy can be elsewhere other than in Ovary. This is called Ectopic Pregnancy. In such cases, fetal sac is seen a little later than usual.
3. Or, its likely that its very early now and in next 1 - 2 weeks, the sac may develop in the uterus.
Transabdominal ultrasound cannot reliably diagnose pregnancies that are less than 6 weeks gestation. Transvaginal ultrasound, by contrast, can detect pregnancies earlier, at approximately 4 ½ to 5 weeks gestation.
So if at 6 weeks, the transvaginal USG has not picked up a fetal sac, you must take the following steps.
1. Get a beta - HCG test. Its a blood test and 100 % confirmatory for pregnancy. People who have doubts with urinary dipstick tests are advised this test.
2. Repeat a Transvaginal USG scan after 1 week for reconfirmation. Also to look for possibility of ectopic pregnancy.
With these two steps, you can be sure about the pregnancy and its site.
Hope this answers your query.
Please get back if you need any further information.
Thanks and Regards
Dr Kiran
Above answer was peer-reviewed by :
Dr. Raju A.T
Dear Doctor, thanks for your valuable advise. As suggested by you we got a Beta HCG done today. The reference level is 524 mIU/mL, which suggests a pregnancy of 4-5 weeks according to my report by Religare SRL. But as I told u earlier that my last period came on 23 May and the ultrasound done on 8 July showed no signs or sac in the uterus. Even a trans-vaginal ultrasound showed no sac at all. But there was one unusual instance in my last period, which I forgot to tell you. My date started around 23 May, but last time the bleeding was unusually long for around 12 days. Also one instance is that the home kit urine test on 23 XXXXXXX was a strong positive. But the urine test yesterday (on 10July) was only a weak positive.So should I start counting my pregnancy date from around 5 June? ( 12 days after the period bcoz of bleeding). Also doctor I wanted to know what should be my further course of action? Is there any chance of my conception? Or will I have to abort? Pls suggest
Hi,
Your beta HCG is definitely suggestive of Pregnancy.
You must undestand, you would have conceived only after your periods got over last time. Now if you had 12 days of bleeding from May 23rd, you could have conceived only after XXXXXXX 5th. Its likely that you might have conceived around 10th to 15 th of XXXXXXX In this regards, its quite early and the Ultrasound might not pick the fetal sac. Yes you should take XXXXXXX 5 th as your LMP.
You should get Ultrasound scan weekly for next 2 - 3 weeks. A transvaginal USG will be the preferred option. This will likely pick up the fetal sac in coming weeks. Also this help to differentiate from ectopic from normal pregnancy.
Please don't think about abortion. As of now its too early.
So please be reassured.
Wish you a great health and my best wishes are with you.
Thanks and Regards
Dr Kiran
Your beta HCG is definitely suggestive of Pregnancy.
You must undestand, you would have conceived only after your periods got over last time. Now if you had 12 days of bleeding from May 23rd, you could have conceived only after XXXXXXX 5th. Its likely that you might have conceived around 10th to 15 th of XXXXXXX In this regards, its quite early and the Ultrasound might not pick the fetal sac. Yes you should take XXXXXXX 5 th as your LMP.
You should get Ultrasound scan weekly for next 2 - 3 weeks. A transvaginal USG will be the preferred option. This will likely pick up the fetal sac in coming weeks. Also this help to differentiate from ectopic from normal pregnancy.
Please don't think about abortion. As of now its too early.
So please be reassured.
Wish you a great health and my best wishes are with you.
Thanks and Regards
Dr Kiran
Above answer was peer-reviewed by :
Dr. Raju A.T
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