Patient :Hi, I miscarried several months ago and am pregnant again, 5 weeks 2 days. I had an ultrasound yesterday and only saw a gestational sac, no yolk. My progesterone has been dropping over the last 8 days from 50 to 30 to now, 20, and I have been placed on suppositories. I have no symptoms and feel really good, too good I fear. Should I be preparing myself to miscarry again?
Thank you for your question. Progesterone is a hormone that maintains the lining of the uterus to facilitate the implantation of a fertilized egg in the uterus, where it will go throughout the duration of the pregnancy. The decrease in your progesterone levels may increase your risk of having a miscarriage, and as a precaution, progesterone suppositories were likely prescribed to maintain the uterine lining, thereby reducing the risk of a miscarriage. Since you have had a previous miscarriage, the risk of miscarriage in a subsequent pregnancy is increased.
Regarding your ultrasound results, inability to visualize the yolk sack on ultrasound may be due to the fact that it is early in the pregnancy or a miscarriage may have occurred. The yolk sac is the first structure to be visualized on ultrasound during the early stages of pregnancy at around 5 and a half to 6 weeks. Since you are at exactly 5 and a half weeks, it may be still a little early for this yolk sac to be seen on ultrasound.
It is very important that you what out for any of the symptoms that you may experience if you are about to have a miscarriage. The first of these is bleeding which can start as light spotting to heavy vaginal bleeding. This would be accompanied by abdominal pain, lower back pain, cramps, weakness and even fever. Should you develop any of theses symptoms, go to your nearest emergency room immediately to undergo evaluation.
We recommend that you pay very close attention in the up coming days to week. We want to reiterate that if you experience any of the aforementioned symptoms, please seek medical attention immediately in order to save the pregnancy.
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