Hi Doctor Today I got the USG report for my wife

Patient

Q: Hi Doctor

Today I got the USG report for my wife who is 10week pregnant
The report is saying

Gravid uterus shows a small gestational sac with foetal node with endometrial cavity.

LMP:24/03/2015
POA: 10 weeks 3 days
CRL:1.52 cms correspondce to 8 weeks gestation
Gestational sac measures 3.49*3.87*3.91
Corresponds to 9week maturity
Conjugate gestational age: 8+ wks
No feotal cardiac pulsation is seen

Decidual reaction is unsatisfactory.
Cervical Os is closed
A large heterogenous SOL of 8.88 cms*7.77cms*13.9 CMs is seen at anterior and left wall of uterine body-subserosal fibroid

Impression: missed abortion in a lady with large subserosal fibroid.

Please suggest me the fact on the report. What does it all means ???

Plzzz

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,
I would like to state that the result of the ultrasound report is not good, in the sense that there is no heart beat of the foetus and the baby is dead. Baby had grown for sometime and then the heart beat has stopped and hence the growth of the foetus got restricted to 8 weeks when it met its demise.
The decimal reaction which is due the growth of the foetus around the gestational sac being unsatisfactory indicates improper growth and development and a case of missed abortion. Missed abortion means a foetus with no heart beat but has not been expelled out naturally out of the uterus by nature yet. Unfortunately the dead foetus has to be removed with D& C.
Also there is a large Fibroid outside the anterior wall of uterus which is not affecting the endometrial cavity and is not the cause of the foetal demise. This would require a surgical removal as it may cause other pressure symptoms and pain, hence should be removed before next pregnancy is planned.
The cause can be congenital or genetic which cannot be commented up in such an early pregnancy demise.
I hope i have answered your query in detail,
Wishing her good health,
Regards

Comments / Follow Ups

Patient: Thanks for your reply doctor. Can you suggest whether I would go for another USG to reconfirm the same
Doctor: Hello,
Its a missed abortion and such reports are usually issued only after a repeat confirmation of the same considering the sensitivity of the issue. There is hence no need for a repeat. She should be planning for a D&C.
Regards

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