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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Does A Small Fetus Size Necessarily Indicate A Possible Miscarriage?

Hi Dr Samuel,



I am 40 year old and having first pregnancy(natural). The first day of my last menstrual period was 31st Oct 2013.

I went for my first ultrasound scan on 17th Dec 2013, it supposed to be 6 weeks 4 days but there was no fetal pole found except a sac/water bag. 2nd ultra sound was done yesterday 26th Dec 2013. Fetus is very small compared to what doctor expected to see as a 8 weeks fetus and worst thing is there was no heart beat detected. Doctor commented i will have miscarrige these few weeks. He scheduled me to go for 3rd ultrascan and to do a D&C if result turns negative next week.



I guessed my fetus size is about 6 weeks. Would it be possible that my ovalution date was delayed and caused the fetus much smaller to the weeks it supposed to be? I have no bleeding or cramping till date, should I wait for another month to confirm the fetus is abnormal before doing a D&C? The doctor has commented 99% of my pregnancy is unhealthy as I am 40. Do I need to go for blood test to check my HCG level before any decision making?



I would be most grateful for you advices.



Many thanks & kind regards,

Cynthia
Tue, 31 Dec 2013
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OBGYN 's  Response
Hi Cynthia,
By 6-7 weeks, there should be a heat beat detected. In your case you are now 8 weeks. There should have been a heart beat by now. I agree with your doctor, that you may very well have a missed abortion. There is no need to get a blood test. The best you can do is repeat the ultrasound after 2 weeks. If the result is the same, a D/C is advised.Early ultrasounds are very accurate with dating. So with a history of regular cycles,its unlikely your dates are wrong.
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Does A Small Fetus Size Necessarily Indicate A Possible Miscarriage?

Hi Cynthia, By 6-7 weeks, there should be a heat beat detected. In your case you are now 8 weeks. There should have been a heart beat by now. I agree with your doctor, that you may very well have a missed abortion. There is no need to get a blood test. The best you can do is repeat the ultrasound after 2 weeks. If the result is the same, a D/C is advised.Early ultrasounds are very accurate with dating. So with a history of regular cycles,its unlikely your dates are wrong.