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Determining the viability of early pregnancies

Catherine McDiarmid-Watt | Monday, April 15, 2013 | 0 comments

Baby And Dad Sleeping, by Vera Kratochvil
Case 1: A repeat ultrasound 6 days after the initial one revealed no change: a persistent empty gestational sac without a fetal pole.

The evidence pointed to an inevitable abortion [miscarriage]; however, the patient's stable condition and the clinician's skepticism about the available information prompted further waiting.

Two days later, the [beta]-HCG level was 29,000, and a third ultrasound 13 days after the original one demonstrated a viable intrauterine pregnancy corresponding to a fetal age of 8 weeks.

The patient subsequently gave birth to a normal male infant at term.

Case 2: At 7 2/7 weeks a pelvic ultrasound examination was obtained. It indicated a gestational sac of 22 mm mean diameter, which corresponded to an age of 7 weeks.

No fetal pole was visualized, however, and the possibility of a blighted ovum or an incomplete abortion [miscarriage] was raised. One week later the physical examination was unchanged.

The patient's [beta]-HCG level that day (8 2/7 weeks) was 123,000 mIU/mL; 48 hours later the level was 50,840 mIU/mL. The patient was informed of the significance of the results and advised to repeat the tests in 1 week.

The following week the patient's [beta]-HCG level was 710,000 mIU/mL, and a second ultrasound examination 2 1/2 weeks after the initial study demonstrated a viable 9 1/2-week fetus.

The patient gave birth to a normal female infant at 42 weeks.

Photo credit: Baby And Dad Sleeping 
by Vera Kratochvil

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About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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