No heartbeat during sonogram, Dates don't match.

Patient

Q: Yesterday I received my first sonogram. I was expecting to be 7 weeks 6 days but the baby was only measuring to be 5 weeks 6 days. While that is possible because my periods are off, I was and still am extremely upset we did not see a heartbeat. I have to go back in 3 weeks to re-evaulate. I didnt even get to meet with the doctor, only the sono tech, and she did not seem concerned. I am having very bad anxiety now because I hardly have any symptoms, I had tender breasts but today they are not at all. No vomiting or nausea. I'm very upset. Not sure what to do.

Symptoms:  Tender breast, Frequent urination
Images: 
No heartbeat during sonogra...-1
Doctor

A:   Hi,
Thanks for the query.
I understand your concern.
Sometimes in early months of pregnancy around one week disparity can be considered between the gestational age by ultrasound and the gestational age calculated according to the last menstrual period.
But two weeks disparity at this gestational age is somewhat abnormal.
The possible causes according to your history may be irregular menstrual cycles leading to incorrect calculation of dates or arrested development of the baby.
Usually transabdominal ultrasound can detect the fetal heart beat after completion of six weeks of pregnancy.
As your ultrasound is showing the gestational age as 5 weeks and 6 days, better to wait for two to three weeks and repeat the ultrasound as suggested by your ultrasound technician.
In case of viable normal pregnancy, fetal heart beat can be picked up by that time.
If ultrasound doesn't pickup fetal heart beat even after two weeks, there is possibility for non viable pregnancy.
Symptoms of pregnancy may vary with gestational age.
Depending on symptoms we cannot come to one conclusion regarding continuation or termination of pregnancy.
After review ultrasound, depending on the result you can plan further management with your doctor's advice.
Take care.

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