Severe Cramping and Empty Gestational Sac - Advice Please!

[Rebecca2494]

Hi,
So I’m around 5 weeks + 5 days pregnant and for the last week I have been experiencing mild to moderate ‘period like’ pain across my lower abdomen which I presumed was normal due to my uterus stretching. However, yesterday while at work I had severe cramping which lead me to feeling faint, I had blurred vision, cold sweats and almost passed out. I ended up in the EPU where they did a transvaginal ultrasound to check for ectopic pregnancy. The midwife said that she’s certain it’s not ectopic, however she could see the gestational sac, but no yolk or fetal pole was present. She said usually at almost 6 weeks she would expect to see at least something by now and to go back in 10 dayss_ to see if there are any changes.
All of this had got me petrified that I may be miscarrying. I’ve been obsessively reading about blighted ovum’s and MC horror stories. This is my first pregnancy so I’m completely new to all of this. I’ve also been reading that it can be common to not see anything on ultrasound this early, but that alongside the severe pain and almost passing out has got me really worried.
It might be worth mentioning (sorry tmi) that I suffer from IBS and every time I get these period like cramps it’s usually followed by getting the urge to go to the loo. Not sure if there is a correlation between IBS and uterine-like cramping?
I know there’s no definite answer at the minute and I’m just going to have to go through this long dreaded wait until next Saturdayy_, but was hoping that someone may have had a similar experience?
Sorry for the long post!!
Thanks in advance

Hi @Rebecca2494 I’m so sorry you are going though this. I can’t really offer much advice other than to say I’m in the same boat as you so offering my support and sympathy. It’s horrible. I am 6+3 ame went for a scan due to pain to find there was a sac and yolk sac but only measuring 5+4. I have to go back in 2 weeks.

Are you certain of your dates? Could you have ovulated later in your cycle?

It’s so horrible being in this limbo - sending hugs x

@Honey2 - thank you so much for your reply.
So I'm counting my dates from the first day of my last period, however I'm a late ovulator with a short luteal phase. I tracked my ovulation last month using clear blue ovulation sticks and according to those I ovulated around day 21/22 of my cycle (12th-13th May). I'm wondering if late ovulation actually affects your gestational age, if you're going by your last period?
For example if I ovulated a week earlier (CD14) that would actually in turn make fetal development a week ahead? Sorry I know I'm waffling now!! - this is my first pregnancy so I'm not a pro with this stuff

The pain that I'm experiencing however is very very severe cramping and coming on every few hours now, that alongside the midwife saying my sac is irregular is not filling me with much hope.Still no bleeding yet though.

@Rebecca2494 yes gestational age is more accurate if you go from ovulation - nhs just use last period because for most people ovulation tends to occur around 2 weeks after first day of last period. You can get online calculators that tell you due date based on ovulation - try that. If you ovulated on 12/13th you’d be 5 weeks +1 or 2 days. However I don’t want to give you false hope, if the midwife sounds doubtful I guess she know what’s she’s looking at - I’m really sorry.

@Honey2 - that's really helpful to know, thank you. I'll mention it on my next scan.
I guess it's just a waiting game now. They've moved my scan forward to Monday due to the pain becoming more intense.
Thank you for your advice and kind words x

If you have late ovulation it will definitely give a different fetal age. I had periods every 6 weeks. When I went to my scan at 11 weeks I measured 2 weeks behind at 9 weeks. When I mentioned the period lengths I was told that I would have ovulate at 4 weeks instead if 2 weeks. With my second pregnancy a similar thing happened

Hi @Rebecca2494, did they give you the measurements for the gestational sac? Sometimes this can tell you that the pregnancy is not viable.

I had an anembryonic pregnancy discovered in 2019 when I thought I was about 7 weeks. There was a sac but no embryo. They were very hesitant to tell me whether or not they thought it was a miscarriage. The uncertainty was driving me mad so I went home and was able to find out that with the measurements of my sac there was really no chance it was a viable pregnancy.

I now have a healthy 16 month son who was conceived shortly afterwards. I found the miscarriage absolutely devastating but it did get easier with time and seeking support from close friends and family.

@JustACosmicGirl Thank you- this might make more sense as to why my sac is empty if I was actually only 4 weeks and a few days at my last scan.

@coconutlatte44 Unfortunately they didn't give me any measurements, but I'm there again tomorrow for another scan so I will make sure to ask. The whole process is mentally and physically draining. I'm taking co-codamol for the pain as advised by the midwife, but it's not even touching it. Im constantly paranoid that I'm about to start bleeding, but nothing yet. Did you bleed straight away, or did it come on later?

Hi @Rebecca2494
I know, the waiting is just so awful. Looking at your dates and your late ovulation, there is a chance that it's just too early, but along with the severe cramps I would probably be concerned that it might not work out for you this time.

I had a tiny bit of spotting with my first mc (really the tiniest bit) which led me to the EPU. My second mc (after my son) I had no blood at all, I just went in for a private scan for reassurance and got the bad news. I ended up having the surgical management for both as my body didnt seem keen to process the loss naturally.

However I'm concerned about how much pain you're in. If it continues I would push for the EPU to see you again sooner than 10 days. I'm surprised they would leave you in that much pain for so long.

Just a quick update- I had my scan today and it's good news! Turns out my dates were wrong due to me ovulating a week late, it's essentially set me back one week.
Everything is looking as it should be at 5 weeks +5. Gestational sac is now a regular shape and tripled in size since last week, yolk sac and fetal pole are now present and we could even see a little heart beat!
The midwife didn't seem overly concerned about my cramps and said that it's probably down to my uterus stretching alongside my IBS. Overall a massive relief!
Again, a huge thank you to everyone for all of the replies, advice and support!

@Rebecca2494, fantastic news, congratulations! Fingers crossed that the next few weeks pass uneventfully and that your pain subsides. :)