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.

Sticky thougths also.. i think you should name and shame the hospital!!

Oh Havingkittens i too are sending sticky thoughts and hope and pray everything is ok. Please do come back and tell us.

Hope you are feeling well too enni and not going through the awful sickness or heartburn yet.

enni hope things are going well.

I have just read the whole thread and I am so shocked.

First of all congratulations.

This has worried me, I had a mmc almost 4 years ago and I was ten weeks but measuring seven. I was told I also had a ectopic pregnancy but in my ovary. There was flickering and movement in both sacs. It took them a week to tell me that the ovary pg was just a cyst and that the pg in my womb (also retroverted) was not viable and the flickering was caused because i wasn't laying still. I had the ERPC. Now I'm worried that it was actually alive and may have been viable. i didn't ask the right questions and I didn't know enough information.

I really hope you complain Enni, complain like there's no tomorrow. Someone might actually go through with their recommendations of ERPC and abort their wanted and viable baby.

Having kittens how are you doing?

enni - just come across this and am appalled at the treatment you received. I hope you do find the strength to complain. If you do then you may find the information from the Early Pregnancy website useful - it has examples of a much better model of care, very little of which your experience matches :(.

I'm lucky in that whilst my local EPU is in the same building as all the other maternity stuff, it shares a floor with the gynae clinic (nothing pregnancy related) and has its own waiting area, scanner, etc. The staff there are also very sympathetic and fantastic.

Fingers crossed that your pregnancy carries on healthy and as relaxed as its possible to be :)

Thanks for asking Lilysma, I spent the last few days doing ok and trying to keep an "It's not over 'til it's over" attitude. Being busy with work has helped a lot. Today has been a different story, I've been feeling miserable, scared and very tearful all day.

I still have some pregnancy symptoms, unlike when I had my last two miscarriages but I've also read that with a blighted ovum (which I guess if what they've seen isn't a fetal pole after all, that's what I have) pregnancy symptoms can carry on so I am trying not to clutch at straws.

I read your thread a couple of weeks ago, I am amazed. Huge congratulations!

and good luck havingkittens.

gosh!how scary,this also happened to my friend her dd is now 9.I must admit after speaking to the mw and sonographer at my local hospital when they didnt seem to know what i was tlaking about re downs screening(i had researched it fully as i am 43) i opted for the privte scan at the fmc in harley street and am now even more glad that i did.Good luck enni you deserve a dream pregnancy.

Hang on in there having kittens!

It is so hard when you can't really trust your body but it's telling you that you're pregnant, isn't it?

I found the only way to get through the weeks between my scans (at the first scan the sac was small for my dates and I had to wait 2 weeks for the next one) was to listen to my body and accept that as far as it was concerned I was pregnant until proven otherwise. So I reckon clutch away at those straws. If it is bad news it will come when it comes...

But there were definitely up and down days. Do check in on a down one - maybe start a new thread!

Dear Enni, congratulations on your pregnancy and for trusting your instincts. Just thought I'd let you know that in a recent baby magazine (think it was Prima baby or Pregnancy&Birth but I'll check the publication/month) there was a woman recounting a similar story who actually went ahead and had the early surgical termination after being told the foetus had died... and then discovered she, thankfully, was still pregnant. She should have been given a non-surgical termination - tablets etc - for the stage of pregnancy she was at and thanks to the incompetence of her obst. was offered a surgical termination. This turned out to be the best thing of course as the fetus survived and she now has a beautiful baby.

I had an early scan and was told they couldn't find the foetus, although the yolk sac and gestational sac were present. Was told to come back in a few weeks but was warned foetus may not develop and may miscarry. I knew I was less pregnant than my Last Menstrual Period date put me as I have a long cycle and normally ovulate around day 22-25. The midwife was rather dismissive of this though when I tried to tell them although nothing near the same attitudes you have come across. I'm 37 weeks pregnant now... It caused a lot of unnecessary worry though.Its unbelievable that their incompetence, and refusal to believe that their judgement may have been flawed, could have resulted in you terminating a healthy baby. Best of luck for the future, and seek legal advice or consider going to the press. Your story could help other women realise that, although the majority of midwives etc are excellent, there are circumstances when they should trust their own judgement over the decisions of the medical profession = particularly midwives as obstinate and unprofessional as yours!

Congratulations on you pregnancy, I hope it goes well x

Congratulations, so pleased to hear about your scan! :)

Lilysma, thanks for checking in on me. Unfortunately luck wasn't on my side again this time. Back to square one. Best of luck with your pregnancy, hope all goes well for you. x

Really sorry to hear that Havingkittens . I hope you are getting lots of TLC and are being very kind to yourself. That was a hard way to lose your baby too. I guess there is no easy way, but it was particularly drawn out. So sorry for your loss xx

So sorry to hear that Havingkittens . Make sure you take time to grieve for your little angel and look after yourself x

Thank you. Unfortunately I think that's something you set yourself up to when making the choice to have early scans. I've had 3 losses this year and each has been similar in that I've had to go back a couple of weeks later to see if there has been any growth. This one was odd because I had been told it was over and then suddenly that it may not be. Although on the up side, the first consultant who told me the bad news in the initial scan I posted about was very curt and abrupt with a poor bedside manner and the guy who brought me back with the possible doubt and then the follow up scan yesterday was an absolute sweetheart who treated me with a lot more compassion which really did make all the difference. He has already emailed me to see I'm ok after todays ERPC and sent me some information that I asked for.

I am doing ok. Sadly after so many blows I think each pregnancy brings less and less expectations, so the bad news is less of a surprise these days and I am better equipped to deal with it. Don't get me wrong it is still a big wrench and I'm pretty scared about the future but I will give myself to get over this experience before I decide what to do next.

I hope Enni is doing well and wish the best to all of you who are also pregnant.

You are a very brave lady and i so wish you all the luck in the world in having your own baby someday x

Sorry to hear that Kittens...

Like you say it doesnt get easier but you get somewhat hardened to it.

I read a good saying somewhere which is kind of what i keep in my mind after repeat losses..

"Hope for the best but always prepare for the worst"

Very true.

Thoughts are with you hon and good luck for the future. xx

DEAR ENNI,
this page is a real boost for me as i went for a scan 4 weeks ago (6weeks)and they could only find a gest sac, they asked for me bk 1 week later(7weeks) and there was a geast sac fetal pole and yolk sac but still no HB :( i was asked to return 2 weeks later (9weeks)the baby had grown 1 mm in that time but there was a HB but is was faint and slow while im really worried everyone reminds me that alittle grwth is better than none and a slow HB is better than no HB whats your thoughts on this i hope my story ends like yours and it is just a slow developer the hospital told me the chances of a heart beat when i return are slim but also said there is a chance it could sort its self out iv been left all over xmas worring and wondering if i was gunna miscarry or if there was gunna be some more improvement when i return although there has been changes evrytime i gone bk it just doeant seem to be enough for us to walk away with hope of this pregnancy lasting x

Hi Enni,
Congratulations on your pregnancy and fair play to you standing your ground.
I should be 11 weeks pregnant tomorrow and due for my scan next Thursday but I experienced light bleeding on Tuesday so they booked me in for a scan today.
Like you they could not find anything through the scan on my tummy so had to do an internal.
They found a fetus 4mm long but no hearbeat and said I was only 5 weeks and 6 days pregnant. The nurses, doctors etc were very confused as the sac is the perfect size. They said if I had miscarried the sac would have been a very different shape.
As they can't say for sure it is a miscarriage they want me to have another scan in 10 days.

Hi Enni.. I am facing the same situation as you had faced. I have no symptoms expect for severe hungriness. I was undergoing infertility treatment and got confirmed with my pregnancy (LMP - Aug 20th).

My first vaginal scan happened when I was 7 weeks 4 days (14th Oct) and I was told I had a very good heartbeat (135BPM). However, CRL was measuring 4.8 mm which would be for 6 weeks baby. I was then asked to come back for second scan which happened today (22nd Oct) and the stenographer was different person than my last visit. He said the heartbeat is low this time and CRL measured to be 3.2 mm which is less than my previous scan and I was told there is a high chance of miscarriage. I got so disappointed when I heard that. I thought how can a baby shrink in its size when we can see the heartbeat and I found this post. This is my first pregnancy and I am really hoping that my pregnancy will continue without any issues as yours. I am planning to go fr private ultrasound and take second opinion.

Please share if you had any pregnancy symptoms when u were going through that situation.

This thread is four years old shilsweety. You'd be much better off starting your own thread.

Hi Enni, thank you for posting such a hopeful outcome. I went for scans at 7w 8w and recently 9w5d. 4 different Doctors gave me a negative diagnosis, saying they are 95% sure the baby is gone. The fetal pole is only at 3mm in all scans. There was no growth at all. I'm now waiting for nature to take it course. But I still feel hopeful for some reason. Praying for now and hoping for a miracle. I shall go for a scan at 11th week. Though chances are slim, really wish there will be a miraculous outcome too.

I'm 8 weeks pregnant went for early scan today said my sack was measuring 6+1 babys 4mm but no heart got to go for another scan next scared my babys not going get a heart beat but I don't pray but I will every night because really want this baby after 2 miscarrages last year

I'm sorry @Nicolalmartin that's ever so frightened no and upsetting.

This thread is 8 years old though. You'll probably get more support if you start a new one. Hugs.