Reassurance - should be 8 weeks, but dating 6 with “imminent miscarriage” despite heartbeat

[CustardCream31]

I’d really appreciate any explanation/guidance/similar stories after my scan yesterday at EPU. I’m feeling confused and worried. I have very little faith in the NHS sadly due to decades of failings, and also negligence in my last pregnancy and birth 8 years ago (resulting in an EMCS and a 2 week hospital stay amongst a plethora of other issues).

Yesterday I had a repeat scan at EPU, following a scan 2 weeks ago after a minor SCH bleed, which has since stopped. I should have been 8 weeks on the dot yesterday. The nurse and sonographer were very blasé about my appointment, heard very clearly laughing and joking loudly between patients in the deathly quiet EPU waiting area filled with worried women. Long story short is my last scan 2 weeks before showed a sac and a yolk but no fetal pole. This time, they did an abdominal scan and it showed a small pole and a heartbeat. TVS done due to retroverted uterus and how early it is, and them also complaining that the scanner itself was awful. They also admitted they had spent the morning moaning about other scanning staff. This did not give me confidence in them at all. The nurse took one look and said there hadn’t been enough progress and to expect a miscarriage. She gave me advice on how to handle the bleeding, booked me another scan for a weeks time and that was it. I was in shock so couldn’t process what to ask, but it feels crazy that there’s now a heartbeat but I’m being told to prepare to lose our tiny baby. My husband and I are devastated and confused. We have now booked a private scan for tomorrow because I can’t stand feeling like this for a week without proper context. I’ve tried calling EPU 4 times today with no answer to ask them, which happened before when I was bleeding so ended up calling a neighbouring hospital who emailed mine to get them to call me (24hrs later…). They are now are shut for the weekend.

The print out they gave me says the following:

Gestational Sac: present. Gestational sac size: 26 mm x 20 mm x 10 mm.
Yolk Sac: present.
Embryo present. Fetal heart activity present.
Gestational Sac (Mean) 18.7mm
Gestational Sac Volume 2.7ml
Yolk Sac (Mean) 5.4mm
CRL 3.9mm
Diagnosis based on ultrasound findings: Live intrauterine pregnancy.
Fetal pole seen with FH however, insufficient progress since previous scan.
Likely iminent miscarriage, rescan in 1 week.
Summary of ultrasound findings: Fetal pole with FH, but insufficient progress.

I’m really worried that because of the “rubbish scanning machine”, the fact I have a retroverted uterus and that they seem to think my dates are solid (despite only having 3 periods off the pill before falling pregnant, ranging 29-31 days) they have written off this pregnancy and told me to expect the miscarriage.

I obviously fell down the Google rabbit hole and found so many women on forums who had the same but then it turned out fine because there’s such a tiny margin for measurements at this size. But of course then there was the not to positive stories, which I am realistic in understanding this could very well be the case for me. “Dr Google” said a large yolk sac is also a big risk factor, which I think mine is? But this wasn’t explained to me if so, just what I’ve deduced from Google.

I don’t have a midwife yet. EPU aren’t answering. I’m a mess. I just want to understand why I’ve been told this. I know the scan tomorrow is very unlikely to tell me much else, but I stupidly found some threads where the NHS scans this early were so wrong compared to newer tech and less rushed staff in private settings. But then I might be giving myself false hope.

LMP: 12.09.2024
Likely positive OPK: 26/27th Sept
First positive pregnancy test: 13.10.2024

Any advice on the above would be appreciated.
Thank you very much.

No one on here can tell you anything at all. Some people in the same boat will have babies at the end of a time like this and others will have miscarried.

attend the private scan and go from there

Hi OP, sorry you're going through this.
It does read like you are quite consumed with anger towards the NHS because of your personal experiences with them but it's important to try and separate this current situation from the past or it may cloud your judgement.
This is a completely different pregnancy and different circumstances.

Firstly, it sounds like the sonographers concern is due to the progress made since the last scan rather than being set on any certain dates?
Weeks 6 to 8 in particular are especially high risk so even seeing a heartbeat at 6 weeks offers no guarantees unfortunately, even when everything looks perfect. The only thing that can give you the reassurances you crave is time. I know it may not seem very sensitive but they have to try and prepare you that this may not have a good outcome, it could go either way at this stage which is what they have said on the report.

I too had a scan at 6+1. There was a heartbeat but I was measuring 12 days behind LMP (not surprising as I was having very long and irregular cycles). I went back 2 weeks later and the baby had grown proportionately in that time and the heartbeat was stronger. I am now 20 weeks, baby is cooking nicely and still measuring 10 ish days behind LMP. I am acutely aware that it doesn't work out this way for everyone.

I understand your distress and wanting another scan asap but it can't really tell you more than what you already know at this stage. You mentioned repeatedly trying to call EPU, what is it you want from them right now? You will need to wait to see if your baby continues to grow and develop at the appropriate rate, nobody can tell you anything before that.

Good luck.

Thank you, I do really appreciate the balanced reply and perspective. I know you're absolutely right, and I just need to take each hour as it comes... it's just so hard and so crushing.
Sorry, I should have specified I was trying to call them to change the time of my next scan as I realise it's booked during a school event I'm attending, and also to ask them if there were any other warning signs on the scan. I know it can't change the outcome, but I like to be informed.

Hi OP, I'm so so sorry you're going through this. There is nothing worse.
No one here will be able to tell you anything with certainty. Yes there are cases where the pregnancy 'catches up' and has a good outcome. However 2 weeks off in measurements is an awful lot at this stage. While the measurements are teeny tiny, a 6 and an 8 week scan look very very different. It sounds as if your body is still producing HCG so some progress is made, but the reason why it's so slow is the issue here. When your pregnancy falls behind in dates and most likely your HCG is low, the most common reason is that you're experiencing a miscarriage. It's just cruel as your body hasn't quite realised yet.

I can see you've had some bad experiences before so it's understandable how you're feeling. But even if you'd only had positive experiences with the NHS the plan and information you were given yesterday would be the same regardless. All they can do is take a look again in another week to see where you stand. There is nothing any medical staff can do for you except watch and wait. They also have a duty of care to tell you the most likely outcome and not give false hope. As cold as all this sounds, it's would be worse to be given false hope.

Please take time to just be, feel all you need to feel. The next week will be tough waiting and I'm sorry I don't have any great advice to get you through that❤️

I agree with other posters. The staff at EPU don't want to give you false hope. It may all be okay, but no-one can confirm, at this early stage in your pregnancy, that your baby will continue to grow. Look after yourself and I really hope everything turns out well.

Sorry to hear about your experience. It's SO hard waiting between scans, I think that's almost the hardest part of miscarriage. I've had 3 miscarriages and currently pregnant with a 17 week healthy baby. Our 2nd pregnancy we had a similar picture - we had an early scan due to spotting at 5 weeks, which showed a gestation sac and yolk sac - this is completely normal for 5 weeks. Rescan 2 weeks later, there was a baby with heart beat, but it was tiny, and only measuring 6 weeks, not 7. The nurse actually tried to reassure me that it was fine, but because we'd had the scan 2 weeks before confirming we should have been further along I was worried and they booked me for a repeat scan a week later. Sadly the next scan (when I should have been 8 weeks) had no heart beat and had only grown a few days more. It's really awful, but I actually think it's kinder to warn you than to give false hope. Both the 2nd and the 3rd miscarriage they tried to tell me it was fine, when I knew it wasn't and I was then proved right at the rescan. Luckily our 4th baby seems to be going really well though, so it's worked out in the end, fingers crossed :)

I'm sorry you're going through this. Unfortunately it is just a case of having to wait a week to get a clearer picture of what's happening. I've had four miscarriages (and two babies) and I had an ivf pregnancy that measured behind from the start with no heartbeat, then a heartbeat but still measuring behind, then the next week no heartbeat. My now 1 year old was an ovulation drug pregnancy, so again clear dates, but she also measured behind by I think 6 days, and did make it. Along the way of the 4 mc I encountered positive staff and less optimistic ones. They just can't know which way it will go often. The wait is always horrendous. Epu care should be better.

Hey op. Hope your scan went well today and you got the positive news you were hoping for

Well they sound horrible and you should definitely make a complaint.

I have been to EPU with my first pregnancy and was told I’d miscarried, but the midwife was absolutely lovely and kind. Do not put up with this poor service.

I had bleeding in my current pregnancy (now 32 weeks) and went to EPU at what I thought was 6 weeks, I was actually dated 5 weeks there but also there was a heartbeat. The midwife told me that it can vary by up to 2 weeks, and scans at this stage can be inaccurate as the baby is so small.

I would call and complain first with EPU and see if you can get a scan with different staff, but I completely understand why you’d want to book a private scan too.

it’s not over til it’s over, it could go either way but if the baby has a heartbeat I’d say that’s a good sign. Good luck x

Morning,
Thank you so much for your replies and kind, balanced words.
I completely agree I need to take it as it comes, and whilst holding a small amount of hope, I should prepare for it not going well...
The scan yesterday offered some reassurance (and has at least settled the mind for the next week until next EPU scan!!).
The sonographer yesterday really struggled too (damn retroverted uterus!). He measured the baby 0.6mm bigger than 2 days before, but also dated me back a few days? Makes no sense but from Google it looks like size/gestation varies quite a lot depending on the place... heartbeat was still present. I asked him if it was a worry that I should technically be 8 weeks based on LMP, and he said whilst it doesn't add up, it's a not a huge concern at this stage because it's so small and the view is so bad due to my uterus position. He said the 12 week scan is always the best time for due date prediction.
So... onwards, one hour/day at a time. Keeping a little faith that our bean still has a heartbeat for now.
Truly hoping I get different nurse/sonographer at EPU next time (the ones I had a couple of weeks ago were lovely!).
Thanks again for your replies and opinions.
Hope everyone has a peaceful Sunday.