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Onlinedoc
Onlinedoc, General Physician
Category: Health
Satisfied Customers: 2886
Experience:  B.A.M.S with experience in Medicine,Ayurveda, Integrative, CAM
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I would like to know if you believe my pregnancy to be a

Customer Question

Hi there,
I would like to know if you believe my pregnancy to be a normal viable pregnancy or a blighted ovum.
My first hcg level at 4 weeks 2 days since last menstrual period was 142. Three days later is was only 208, which was concerning. 3 days later i did another and it was 502. Six days after the last test my hcg was 1770.
After my last hcg result, i have a travsvaginal ultrasound at exactly 6 weeks from Last menstrul period. But the technician only saw a gestational sac size of 5.5mm and measured the sac at 5 weeks and 2 days. She did not see a yolk sac at all.
I have to go back in 2 weeks time to see if the yolk sac and feotal heartbeat are present.
I am unsure if this pregnancy is viable. I haven't had any symptoms since the pregnancy began apart from tiredness and larger breasts and minor cramps on and off.
I am concerned because i am Rh negative and have had to chemical pregnancies in a row prior to this pregnancy. Any advice/information will be helpful.
Submitted: 4 years ago.
Category: Health
Expert:  Onlinedoc replied 4 years ago.
Hi,
In my opinion you need a repeat scan after 2 weeks to assess the fetal viability and growth assessment is required.
It is difficult to comment on the viability based on these reports with confirmation.
Technically speaking fetal heart beat can be seen at 6 weeks with trans vaginal ultrasound.
Mistaken dates very commonly seen in practice and patients often provide a false date.
I hope this helps
Customer: replied 4 years ago.

Dr Nitika,

I unuderstand i need to go back for another ultrasound in 2 weeks. I just want to know in your opinion, are my hcg levels concerning. What usually happens with a blighted ovum? Should i have been able to see more than the gestational sac via tranvaginal ultrasound. My gestational sac had nothing in it and measured at 5.5mm and the technician dated the pregnancy at 5 weeks 2 days. This cannot be possible because i know when i ovulated. Can delayed implantation be the reason for my low hcg levels and why i could not even see the yolk sac on the transvaginal ultrasound.

Hcg levels taken over a few days can usually show if it is a viable pregnancy prior to an ultrasound. Based on my hcg levels and that they have increased but not doubled. What is your medical opinion through experience?

I am also Rh negative, is there a test i can ask for at my Gp's office to detect if i have developed antibodies against my feotus?

Expert:  Onlinedoc replied 4 years ago.
Medical opinion states that since yolk salk is not seen chances of viability are on lower side.
But i have seen one or two cases similar to your case where even the ultrasonologist had reported missed abortion and some how after 2 weeks fetal heart beat was present.
So at 6 weeks it is difficult to comment on the non viability so early with full confidence and it is ideal to wait for 2 weeks.
Blood test,ultrasound etc are all human interventions and are open to error.So basically i would say you to keep your hopes alive for next 2 weeks and go for a repeat ultrasound.
Customer: replied 4 years ago.
Relist: Answer quality.
Both times the expert has failed to comment on my rh negative condition. i would like a second opinion preferrably from an obstetrician or gynocologist.
Expert:  Onlinedoc replied 4 years ago.
Indirect Coombs test is done for this purpose.
Kindly forgive me for my typing error above yolk salk = yolk sac.