WOMENS-HEALTH Messages for August, 1999: Re: Ultrasound shows fetus 4 weeks smaller

Re: Ultrasound shows fetus 4 weeks smaller

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Sat, 21 Aug 1999 21:42:14 -0500 (CDT)

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In reply to: Alisa: "Ultrasound shows fetus 4 weeks smaller"

At Fri, 20 Aug 1999, Alisa wrote: >
>I went to the doctor this week and they did a vaginal ultrasound and saw
>the heartbeat. The doctor said that the fetus looked like it was 8
>weeks 4 days old and set my "official" due date. According to my
>calculations the fetus should be 12 1/2 weeks old! Anything else is
>IMPOSSIBLE!! My husband is in the Navy and left 5 days after my LMP and
>didn't come back until a week ago. The Navy doctor had the audacity to
>ask if I had cheated on my husband and said that there is no medical
>reason for it being that far from my calculations.

First, the doctor was correct to ask you about extramarital relations, as a change in due date by 4 weeks can have a huge impact on your pregnancy, particularly towards the due date. You might be shocked to learn how many women come in and beg their doctors or midwives not to tell their husband that he is not the father of the baby. It gets really tricky when you need to induce labor beause the baby is overdue, but the husband thinks the baby is only 34 weeks! It puts a significant burden on the doctors and nurses, because the husband is usually very upset and frustrated that he cannot seem to get a straight answer from anyone. Just another example of life in the '90's.

There are a couple of possible reasons why there is a 4 week difference between your calculation and the ultrasound. It's possible, although unlikely, that the ultrasound was wrong. However, early ultrasounds tend to underestimate the dute date, not overestimate. Another possibility is that you and your doctor are using different methods to calculate the due date. This is probably the answer. You did not say what your LMP was, but doctors/midwives use a 40 week calculator. This does not really translate into "9 months" because 9 months6 weeks. The extra 4 weeks that create a 40-week pregnancy occur because there are always a few extra days at the end of each month (ie 7daysx4weeks( days, but most months have 30-31 days). These "extra" days add up to equal 40 weeks. Thus, if you are not using this exact same system, or you have not double-checked using the "wheel" at the doctor's office, then this is the most likely explanation. Perhaps a quick call to his nurse, asking to "wheel out" the LMP, would solve the problem!

I hope this solves the dilemma, and puts you back on track for an uncomplicated pregnancy. Best of luck with everything.

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://home.mpinet.net/dahmd

The above is intended for general medical education, and is not for specific medical advice. I apologize, but I am unable to answer personal e-mail due to time constraints.

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