High HCG, No Fetal Pole

Patient

Q: Hello, My wife and I are pregnant for the second time. The first ended and was diagonsed as a blighted ovum. My question is At the first ultrasound all they found was a gestational sack, they did another US 2 days later and found a yolk sack but no fetal pole. The blood tests the first US showed an HCG of 10000, a little less than 2 days later HCG was around 14,500. I know they like the numbers to double but I have also read that over 10,000 it is normal to take in excess of 96 hours for the HCG to double. And I'm just looking to get some reassurance that what I have been told is correct and the everything is going ok. We have another ultrasound this upcoming friday to have another look. Also the Dr. told us that this is not a blighted ovum and through looking on the 3D ultrasound the implantation occured slightly higher in the "corner" and explained the uterus can be triangular so that can effect what is seen on the ultrasound. Any imput would be greatly appreciated ASAP. Thanks!

Doctor

A:   I do understand your concern. The wait for the repeated ultrasound can be emotionally very difficult. Sometimes there is a possibility that the dates are off, and this causes problem with the ultasound findings. If done early, developing baby is too small to be seen on ultrasound until about five weeks of gestation. In this case, the doctor may opt to repeat the ultrasound at a later date. A yolk sac is a VERY good sign though, usually in a blighted ovum nothing other than the gestational sac forms. I hope the input would have cleared some of your doubts, I wish you and your wife well.

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