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Pregnancy

8 weeks, 4mm fetal pole, told to have a D&C

102 replies

enni · 26/11/2010 12:17

Hi,

I am pregnant (I hope) with our first pregnancy. 4 weeks ago, I went for our first scan. At this time I thought I was about 9-10 weeks (based conception - my husband travels alot so I thought I knew the conception date), however as my cycle is irregular it could have been alot earlier or later. The sonographer was very good, and took quiet a bit of time. She could only see the gestational sac, but no fetus or yolk sac on the abdominal scan so did an internal scan. Here she found a yolk sac and fetal pole around 3 mm and estimated that I was 5/12 - 6 weeks. Doing some fast mental arithmetic I thought this was not possible, based purely on when we got a positive pregnancy test (exactly 5 weeks prior). She also couldn't find a heart-beat but was not too concerned about this. She did however refer me to the Early Pregnancy Unit for another scan a week later.

I then did some proper calculations with my calender at home, and spoke to my sisters who all confirmed they ovulate late in their cycles and tend to have very high pregnancy hormones (often the doctors suspecting twins when there is only 1). So I was quiet relieved - 5 1/2 weeks was very possible and everything else (gestational sac, yolk size etc) all aligned with the obstetric information I found on the internet.

When I returned the following week for a second scan, I was seen by a different sonographer on a different machine and my experiences could not have been any different. This time she spent less than 2 seconds on the abdominal scan before declaring "I can find anything but an empty sac, this does not look good, I think you have miscarried." I am not kidding about the 2 seconds either, it was 2 very fast swipes of the wand over my tummy, so fast my husband didn't think she'd looked at all.

She then offered to do the internal scan if I wanted it, but she doubted it would show anything. Naturally I said yes and we had the internal scan. This time however, she did the scan while I was in the same position as I had been for the abdominal scan. In the first scan when we moved to do the internal scan she asked me to lie back on a large foam pad. This placed my body in a very different position to the one I was in now. The sonographer was very surprised to find (and expressed her surprise) a yolk sac and fetal pole, the fetal pole now being 6mm. She confirmed the diagnosis of miscarriage on the basis that the fetus should have doubled in size and not grown by only 3 mm. She tried to find a heartbeat, but could not do so. However contrary to the fist sonographer declared that by now a heartbeat would definitely be present and therefore the pregnancy was not viable.

We were then shown in to see the midwife who strongly counselled us to have a surgical misscarriage as the pain of a natural misscarriage would be too much. I was also told they would not allow me to wait more than 2 more weeks to misscarry due to the risk of infection. They were referring to the fetus in the past tense and definite this was a misscarriage. I was in tears at this point and my husband really panicked and upset - he had wanted this baby so incredibly much and is horrified at the thought of me in pain (yet some how is happy for me to give birth without pain killers - that one I can't work out!!! Bless him :) )

All that said, I went home, determined to let nature take it's course. I also read up on the early days of pregnancy and may obstetric texts indicate the fetus grows 1mm a day after 6 weeks. If I had been 5 1/2 weeks with a 3 mm fetus, then it would only have grown 1mm a day for 1/2 a week between scans. Additionally, the sizes all matched up with several tables in several textbooks on the size of the fetus at different times. The gestational sac and yolk sac were all normal. No heartbeat but from what I read this was also normal. So, after a day I decided that they were wrong, I still felt very very very pregnant and so waited 2 weeks for our next follow up scan.

This week we had that scan. Now, according to the first scan I would be 8 1/2 - 9 weeks. And so far, no abdominal scan has shown anything. From what i read, this isn't unusual particuarly if you are overweight (I am BMI of 33) and if you have a retroverted uterus - a common occurance but one I do not know if I have. I also read that in the early days many things can interfer with a good image - air in the bowels, the fetus at the wrong angle to the ultrasound waves, the skill of the sonographer and so on.

I go in for the scan and have the same sonographer as I had at the second scan. This time she did spend more time on the abdominal scan. Around 3 minutes. Found a sac size of 30mm (this lines up with a pregnancy of 9 weeks) a yolk sac of 6 mm (also good) and a 4 mm fetus. On this fact alone she declared the pregnancy failed and the fetus dead. I told her that previously nothing had been seen on the abdominal scan so could we do an internal one. She refused saying it would not show anything and was too invasive. I told her (the truth) that I have had several internal scans, 2 with this pregnancy and at least 4 or 5 during fertility investigations and that I would be happy to do one, begged her for one but she refused. Surely if the baby had died, it's not going to shrink - i've had no bleeding, no cramps so where did the fetus go? Surely if they found nothing on previous abdominal scans only to find a 6mm pole on the internal scan, then 4mm on the abdominal scan could realistically be larger on an internal scan?????

The report that was written up confirmed a failed pregnancy, stated no heart beat was found. Only she hadn't looked for a heartbeat. I know this because they switch the machine into a different mode and various colours appear on the screen etc. This was definitely not done. When I mentioned this discrepency to the midwife she didn't believe me.

So, contrary to medical advice and pressure, and much to my dear husbands worry and concern, I have come home to let nature take its course. I am convinced that I am still preganant and the the sonographer was rubbish at her job. I am also concerned that her findings were not confirmed by another sonographer nor will did they grant my request for a different sonographer. They have not tested my hormone levels and didn't bother with the normal booking bloods as they didn't see the point if as this was a failed pregnancy.

So, one day I am convinced they are wrong, determined to wait as long as i have to to either have a healthy baby or misscarry naturally. The next day I think I am going mad. I don't want to go back for the next scan in 2 weeks as they have indicated that I will "have" to have a surgical or medical misscarriage at that stage if nothing has happened. I know that I am well within my rights to refuse but the pressure is extreme and unfair. Particularly when they refuse a second opinion. So I decided to self refer to another hospital, knowing it will take several weeks for the paperwork to go through and to get my first antenatal check and scan with the new hosptial. Hopefully by then I will be past 12 weeks and everything will be fine.

Am I making the right decision? I know you only have my side of the storey here, I have tried to be as objective as I can. My gut tells me I am pregnant, but sometimes I wonder if i am in denial and being delusional. I don't want to be stressed for the sake of the baby so thought it might help to get my thoughts out here.

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shongololo · 26/11/2010 12:27

could you go private for a scan?