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

[enni]

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.

Now I am normally the last person to say "Sue their arses", but FFS these people were recommending that you KILL your baby due to their incompetence! Words fail me!

On the other hand. Congratualtions! I hope the rest of your pregnancy remains stress free - by God, you deserve that

Enni that is wonderful news - thank god you trusted your instincts! Congratulations and good luck for the rest of your pregnancy :)

What hapened to me with this pregnancy is remarkably similar. I went for an early scan at what should have been 6+6 weeks (due to previous losses) and was told baby was measuring under 4 wks, and was not viable if I was sure of my dates, did I want an ERPC. I said no, went back for a scan when I should have been 8+6, baby was measuring as 6+1, fetal pole but no HB, told again 'pregnancy not viable, have an ERPC'. I refused, as I was suffering from hyeremesis by then, was sure pregnancy was viable. Went back (had to push for this) for a scan when I should have been 12+1...and baby was measuring 12+1, and looked perfectly healthy!

I am currently being booted in the ribs at 33+5 by a baby I was told I should have terminated. I have had further scans (NHS at 20 weeks, private at 28 weeks) and baby is totally healthy! NOT all babies follow the 'normal' growth pattern in early pregnancy, yet the pregnancy can still be fine!

I'm glad you stuck to your guns, OP. Sometimes 'mother's intuition' is the best thing! I hope the rest of your pregnancy is trouble free, and good luck with your baby when he/she arrives!

Yhis might be a very ignorant question, but why DO so many people have scans so early? I guess it must be hard to spot anything at all - so room for error must be huge I know at my 12 week scan the baby was hardish to find initially.....

In my case it was to see if there was a HB due to a previous history of early losses. (Plus last pg ended in a late MC at 19+5, so was VERY nervous)

GOSH! Wow congratulations.... just goes to show huh?!

Blardy nora how many EPRC recommendations may have been done at that hospital where maybe not necessary?! Def complain!!!!

i had a scan 6 years ago, and was told i had lost the baby. they said the sac was deformed??!! and there was no heartbeat, and wanted to surgically remove what was left. i was the same i didnt believe it, i ran out the hospital, everyone thinking i was in denial. my son is now 5 and a half... and perfectly healthy. i would have lost him if i had agreed to the operation.

this was at the same hospital that told me i wasnt in labour with my daughter, i was screaming in pain, so they stuck me in a side room on my own saying i was just constipated, i begged them to believe me, had her 10 minutes later! i think we need to trust our insticts.

Portofino - women have different reasons for very early scans. Women with fertility issues might want to check the pregnancy isn't tubal, women who have had past MCs might like to make sure the pregnancy is viable early on instead of that agonising wait until 12 weeks. Women who have had IVF will often have early scans because of possible complications (ectopic?). I agree that it opens up the room for error, but a competent scanner should still be able to see what's what, and if there's any doubt, she should go for a second opinion.

Hurray, Eni - I'm so happy for you!! I shudder to think at how many people may be accidentally aborting healthy pregnancies Because sadly your story is not unusual. Good on you for complaining - the NHS has been negligent.

But I'm so pleased for you!!

Seconding reshape, portofino women, particularly women who have had MC issues tend to go for scans early to see if anything is there....... reassurance, supposedly :)

This is a good news story :)

Oh it's wonderful! I know my niece who had IVF - success! has had a scan at 8 weeks. They implanted 2 grade A embryos and there is one heartbeat. I am so happy for OP and for DN and yet horrified that medical professionals advocate D&CS at such an early stage when stuff is so easy to miss.

OP congrats on believing in your gut instincts. As an emotional 27 week pregnant woman this has brought tears to my eyes, am just so glad for your happy ending

Portofino I have to bite at that - it is a little ignorant.This will probably sound a bit of a rant but I wanted to explain.

i hope you are never misfortunate to have any pregnancy problems. For those of us that have had the devastation that is a loss or even worse , more than one loss - an early scan can help you like you wouldn't believe. Particularly around the time of a previous loss. some mums experience bleeding pains or symptoms like previous losses and the only way to monitor the pregnancy is scans and bloods.

At week 5 I had the same problems I had when I lost at week 7 and the epu called me straight in. Luckily little bean was ok but they have advised if I have the same again I must come in. Most good epu's will provide good care but sadly it seems not all.

Scans can pick up a lot obviously it's the dates that determine what it seen..as for the incompetence that enni had, that is just not excusable.

rant over! One thing I have learnt from scan clinics is that they are full of people with healthy pregnancies and also those who are awaiting possible bad news so If I ever make it thru this pregnancy I would be so mindful of others. It really is heartbreaking and I wish it was more enjoyable for more of us!

God that does sound like a rant! I dint mean to sound so angry....must be the hormones

I hold my hands up to being ignorant about it. I know dn had an early scan to check all was well after IVF and to see how many embryos had implanted. But I don't know anyone else who had one before 12 weeks.

It is one of those things that MN has opened my eyes to. I feel for anyone that has had difficulties.

Portofino, another reason to have an early scan.... I have a history of twins in my family, and my last period before my pregnancy was extremely light. This could have been because I had just come off the pill a few months earlier, or I could have already been pregnant the month before.
So I wanted some re-assurance that I was carrying just one baby, and that it was indeed conceived in the month I thought it was!

enni I really am delighted for you.

If you need a bit of support in making a complaint to the hospital in question, can I suggest seeing if there is a NCT hospital liaison in your area? They would, I am sure be pleased to support you.

Please do not leave this without a complaint. The hospital PALS need a letter, as does the head of midwifery and they should be meeting with you as a matter of urgency to discuss your care.
Mistakes happen, I understand that, but your treatment has been terrible.

Good luck for the next seven months!

Fucking hell, your story has made my blood run cold.

Complain, and complain loudly. That dreadful second sonographer is still treating other women, day in, day out.

WOW!!!!

Firstly, congratulations!! Thank goodness you stuck to your guns and went with your instincts!!

I cannot believe the way you have been treated and if you had followed the hospitals advice, they would have carried out a completely unnecessary procedure for a viable pregnancy. I would have told them about the private scan to see the looks on their faces tbh!!

I would complain and go to the papers about this disgusting treatment of you.

Keep us updated on what happens, this woman should lose her job tbh. How can she be employed when she is telling women they have no baby when they have a refuses to let them get a second opinion. The possible outcome really doesn't bear thinking about.

What hospital is this? Name and Shame!!

Wow I am absolutely stunned and really thought you were clinging onto false hope I am so very pleased for you - well done for sticking to your guns and yes, please do get in touch with PALS at the hospital to stop them doing this to anyone else.

Congratulations - what a brilliant xmas present :)

Enni, how is everything going with you? I would love to hear how you are getting on.

I am hanging on by a thread just now, this thread in particular!

I am now on my 6th pregnancy. I've had 3 miscarriages and 2 terminations due to fetal abnormalities and having been under the recurrent miscarriage clinic was advised to have early and regular scans. I had my first scan just under 2 weeks ago at what should have been 6+5 according to my LMP. I was told that there was no fetal pole, just a yolk sac but no cause for worry just yet (although he did let out a rather suspicious deep sigh whilst scanning me) and that I should go back 7-10 days later.

I went back yesterday and had my scan in the Fetal Medicine Unit and was told that there had been very little change since my last scan, there was no fetal pole and that I had had another missed miscarriage. I was then sent down to the EPU to be scanned again with a view to making arrangements for an ERPC. The lady who scanned me spent ages and was very thorough and confirmed that she agreed with the first scan results. I then went into the "Special Room" to wait to speak to a Nurse about dates for and ERPC. A date was arranged and then just as I was about to leave the lady who had scanned me stopped me and told me that the consultant that she had shown my scan pictures and notes to was not 100% satisfied with the images and would like to scan me again if I didn't mind.

I went in to see him and he explained to me that he had seen something in the images that was not in the initial scan which may or may not be a fetal pole. He scanned again and got the same impression, freezing and focussing on what had raised his suspicions. In the end he said that although he couldn't promise that there was a good chance of a baby at the end of this there was enough change in size and circumstances since my last scan for him not to be happy to diagnose as a miscarriage just yet, and therefore not go ahead with an ERPC but to come back a week later for another look.

The measurements don't look great it has to be said (even smaller than OPs at 2.8mm) and he said I am still at a very high risk of miscarriage as I should've been 8+3 and the development was very slow and behind what it should be for my dates but we will see. He is going to show my notes to his head consultant today to see if he agrees with the verdict, and will call me later.

Completely shitting myself! I have been doing the classic Googling similar situations and although there are a few heartening stories, particularly on that misdiagnosedmiscarriages.com site but the stories all seem to stop before the 12 week scan and I would love to read that there can be happy endings.

Go for it enni, kick up merry hell. I would in your position. How many more women has this sonographer got it wrong for?
I am so glad you had some good news and trusted your instincts.
If you have lost faith in this hospital now, is there not another NHS unit nearby that you could switch to rather than go the whole hog and have everything privately?

Okay, so now I'm freaking out about my 7 week scan. I read your story thinking the worst and have gone from sadness, to elation, to downright anger on your behalf and that of every other woman scanned by that murderer of a sonographer. I really hope you can find the strength to complain, not just for her ineptitude but her blatantly inappropriate and insensitive attitude. She should be struck off immediately.

On a lighter note, here's hoping the next 6 months are slightly less eventful. Thank god you followed your instincts and what a story to tell the grandchildren! Congratulations! X

Congratulations! I'm so pleased this has turned out well for you.

Personally, I would complain bitterly to the hospital etc but I wouldn't get the media involved. Before you know where you are there'll be a huge number of women who won't have a D&C before dozens of scans. On the whole, sonographers do an amazing job and are very knowledgable. You just managed to get a shite one. Those ones need weeding out, but a wholesale witch hunt is in nobody's interests!

Oh kittens. I can't imagine how hard this must be.

This thread has haunted me, I am so furious and sad that these mistakes can happen. It must be so incredibly hard if you're in a similar position.

Sending you sticky thoughts and a candle.