Due date and development problem

[Adramityon]

Hi, my wife found out on Saturday that she was pregnant. But she had a little bleeding, so she went to the GP who referred her to the hospital's early pregnancy unit. They did a scan and calculated the embryo had probably stopped developing because it was 2.4mm which the specialist said was about 5 weeks. But My wife had told them her last period started on 26 December. That is how they calculated that the embryo should be 6-7 weeks and therefore not developing. We're really confused. She was told to go for another scan in a week or so to see if it has grown at all, but they said they were 'not optimistic'. But the thing is her last period was not normal. There was only a small amount of blood and it lasted about 10 to 14 days. before the scan she gave the date when the blood started and assumed that was the start of her last period. So perhaps it is only 5 weeks old and not underdeveloped after all. Is it worth getting a conception test to see? She's also had quite a bit of bleeding but no cramps so far, but they said it was unrelated... it's horrible to have to wait to do another scan, not knowing if the baby is alive or not. Any advice please?

It's possible everything is fine, unfortunately you will realistically have to wait until the scan to find out how and if the pregnancy is progressing. I'm not sure what you mean by a conception test - do you mean a digital pregnancy test? If so that won't tell you anything at this stage unfortunately.

The best advice I can offer is what I have read on here - prepare for the worst and hope for the best. When is the next scan?

Hi
Yes I meant the test that gives you a gestation age for the embryo. Do you not think it is worth it? I'm hoping it would say 4-5 weeks or something rather than 6-7 weeks. We'll go for a scan in 2 weeks.

What confuses us both is that they say the gestation date is based on the first date of period, but my wife's cycle is very irregular, because she has thyroid and anaemia problems probably. Is the first day of period always an accurate indicator of gestation age? If it's wrong and ovulation occurred later, that means the embryo could indeed have a true gestation age of 5 weeks, meaning it is developing normally. My wife has no idea when she ovulates. She just knows when the blood comes. When a professional says they aren't optimistic that the baby is growing, purely based on the LMP-calculated age compared to the size of the embryo, I find that quite worrying.

The average woman's cycle is 28 days, with ovulation occurring around day 14, so if her cycle is generally a lot longer than that then it could be wrong. When did she get the positive pregnancy test result?

The digital pregnancy tests only go by the levels of hormone in the woman's urine, and the highest they tell you is 3+ weeks, plus they are notoriously inaccurate as hormone levels vary between women so honestly, you would be wasting your money getting one.

Apologies, just realised she found out on Sat. Had she tested prior to this with a negative result?

She did find out Saturday. She hadn't tested before but her period never came and so we did.

It's just that we'll both be worried until the next scan, especially when the hospital told us not be to optimistic. I was just hoping there was some way we can check on things, or prove that her ovulation happened later or something, to help put our minds at ease. She was also bleeding after the scan, and last night before it. Last night it was clotting, then it eased off. Today it was just red blood. Will check with her when I get home from work to see if there has been more bleeding. If it is a miscarriage, she doesn't know what happens after. How soon can we start trying again? I guess the hospital will hopefully tell us that if the time comes.Thanks for your advice.

There's really nothing you can do unfortunately other than wait and see at the scan, unless anything changes and she miscarries prior to the scan.

My miscarriage was later (at 12 weeks) so I can't advise what would happen if she miscarries naturally at this stage. I had to have an ERCP under general anaesthetic as baby had died but my body didn't expel it. I think if she does lose the baby, you can start trying again as soon as she is getting negative pregnancy test results (she won't ovulate prior to this anyway). From my experience, it took around 3 weeks for the pregnancy hormones to leave my system, I had one period, then fell pregnant again that month. I'm due to give birth any day now.

As I said, hopefully her dates are wrong and all of this is irrelevant.

With dc1 I conceived at very end of my cycle so dates went back two weeks at first scan.

I had no idea when I had last menstruated or ovulated, so my dates were purely by baby's size at the scan. Sorry you're going through stressy times - it's really hard to do the waiting even without extra doubt added. Try not to second and third guess yourselves. It'll be what it'll be.

Thanks for advice all. We're very new to this (it hasn't even been a week since she did the pregnancy test). So we went from elation at the start of the week to despondency now. One thing is that we checked back over her past few months of cycle and found that it was average 35 days. But on the form we got after the scan it said her cycle was normal 28-day. Also, one the form my wife submitted before the scan she said her cycle was typically 4-5 weeks, which is wrong. it is 5 weeks at least. If the doctor at the early pregnancy scanning unit was basing her prediction of a miscarriage on her guess of a gestation date (which i guess she based on what my wife said was her cycle), then i believe the embryo has not stopped developing, and is exactly the size it should be... we're obsessing over the details because no one is telling us anything. We are trying to get an emergency appointment with the GP to try and clarify, but i don't know what he can really say. Should we call NHS Direct?

I wasn't in the scan room when my wife was told all this, and when she heard she was probably going to miscarry, she was too shocked to question it. Her bleeding has eased off, but still continuing a bit this morning as a darker colour. This bleeding started after her internal scan. She hasn't had any cramps or pain.

Unfortunately an appointment at the gp at this stage won't help you. You really are just going to have to wait for the next scan, unless you want to pay for a private one in the interim. I know it's horrible to have to wait, but the time in between will hopefully ensure you get a definitive answer at the next scan.

Nothing new to add really, but just wanted to say I had a similar experience - long and irregular cycle, bleeding in early pregnancy and being told the embryo was "smaller than expected" at 7 weeks or so. Had a rescan a week later and it had tripled in size, at which point they officially redated the pregnancy. (There was an 11-day difference between the EDD by LMP, and the EDD by crown-rump length.)

Good luck - please keep calling the early pregnancy unit if you are concerned about the bleeding.

Thank you ThePequod. Although we don't want to get our hopes up too much, what you said is very encouraging. We'll have to wait for the next scan and see. That bleeding she had might be implantation bleeding if its younger than the Dr thought. I just don't know why they tell people these things if they aren't sure. Don't they realise how distressing that news is to expectant couples?

Adram I understand it can be distressing but the alternative is leaving pregnant women completely in the dark, or giving them an unrealistic idea of what might happen (psychologically, very damaging - if the worst happened and the doc had said 'everything is fine it's implantation' a week ago). It sounds like your doc has been very clear and accurate, although it is difficult news to hear. I have been in this situation several times and sadly, for me they was miscarriages.

One thing you could request in addition to a scan is 2 HCG blood tests 48 hours apart. This will demonstrate if the HCG is rising (in which case the pregnancy is growing) or falling (in which case sadly it's miscarried).