WOMENS-HEALTH Messages for February, 1998: Re: no more fetal heartbeat -- wait or get a D & C?

Re: no more fetal heartbeat -- wait or get a D & C?

From: Kelly Shanahan, MD (anonymous@obgyn.net)
Sat, 28 Feb 1998 21:00:06 -0600 (CST)

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In reply to: lgalau: "pituitary adenoma - Dostinex- abnormal,painful periods"

Lisa, I agree with Susan -- this may just be a very early pregnancy, one in which we wouldn't even expect to see a heartbeat yet. My suggestion is to have serial pregnacy hormone levels (hcg) drawn (if they are rising appropriately every 2 days that is a good sign) and a progesterone levle and another ultrasound in one week if the hcg levels are going up.

If this is indeed a miscarriage -- and I sincerely hope it is not -- then you will likely miscarry on your own, without a D&C. This early, Mother Nature usually a good job in emptying your uteus, wihtout the risks of a D&C.

Best wishes, and hang in there.

--
Kelly Shanahan, MD

 At Sat, 28 Feb 1998, Suzanne wrote:
>
>There is no harm in waiting, even though it may be stressful.  If you don't
>wait, you may live with the guilt of "what if."  If you do wait, you may
>still have a miscarriage in the end, but you will at least know you gave
>this baby every chance.
>
>I know personally of 3 different women (and have heard stories of others)
>who were told that they were not carrying viable pregnancies (due to lack of
>growth or lack of heartbeat), and refused an immediate D&C. Two of the 3
>(and several in the anecdotes I've heard) were still pregnant with live
>babies that they went on to carry full term.
>
>If this pregnancy is going to end, your body will probably take care of
>things by itself in it's own time.  If it doesn't, a D&C may be necessary.
>Of course, you have the option of the D&C without waiting, too, and it
>sounds like one of the Dr's you have seen would even do it now, if you
>wanted.
>
>--
>Suzanne S. Powell, ICCE
>childbirth educator & labor doula
>Peachtree City, Ga.
>
>-----Original Message-----
>From: Lisa
>To: Multiple recipients of list
>Date: Saturday, February 28, 1998 12:51 AM
>Subject: no more fetal heartbeat -- wait or get a D & C?
>
>>I have very irregular periods but believe I conceived from January 16 -
>>20 based on having had unprotected sex at that time.  I had a positive
>>home (urine) pregnancy test on February 4.  An abdominal ultrasound
>>showed an intrauterine pregnancy (2mm) on February 13 and the Dr.  showed
>>me a heartbeat on the screen.
>>
>>My Obgyn returned from leave and I went to see her for the first time on
>>February 27.  She was not satisfied with the ultrasound I brought her
>>from the other Dr.  saying that it looked as if he was measuring a yolk
>>sac rather than a fetus and since my periods are very irregular she
>>wanted another ultrasound to get a better estimated due date.  Two
>>doctors performed consecutive ultrasounds vaginally, measured the fetus
>>as 4 mm but neither could find a heartbeat.  My OBGYN said while it was
>>bad news, it was possible that the other DR.  had mistaken my own blood
>>vessel for a fetal heartbeat and that we should hope that it is just a
>>very early pregnancy and I should do nothing for a week, then come in
>>for another ultrasound.
>>
>>Also on the 27th I called the other Dr.  and asked him if he was sure he
>>saw a heartbeat, he said yes and asked me to come in again that
>>afternoon.  He did another ultrasound, found no heartbeat and measured
>>the fetus at 5mm.  He said that I had lost the pregnancy for sure (it
>>had not grown as much as it should have during the two weeks) and should
>>not postpone doing a D & C.
>>
>>I am depressed and miserable.  I don't want to mistakenly kill a viable
>>embryo, but I don't wan't to lay around all week crying and waiting
>>either.  Given the dates of my positive test (Feb 4) and the sizes
>>measured, it is possible that this is a very early pregnancy, or am I
>>holding on for further disappointment?
>>

--
Kelly Shanahan, MD, FACOG
S. Lake Tahoe, CA

note: Opinions here are for educational purposes only. This information is not intended to supplant the need for you to consult with your own physician. It cannot take the place of a face to face consultation and examination.
Sorry, but private e-mails will not be answered.






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