Monday, November 09, 2020

Making sense of early pregnancy scans - part 2




When you can see your baby on the vaginal ultrasound scan, you are going to be very excited because you are one step closer to your dream of having your own baby.
However, the truth is that not every pregnancy results in a baby - and this is as true of IVF pregnancies as bedroom pregnancies. About 15% of all pregnancies will miscarry, and IVF does not reduce the risk of a miscarriage. These are usually first trimester miscarriages. 
Sometimes we can see the baby, but can't see a heartbeat. Please don't panic ! This is quite normal when the scan is done early, because the baby is very small, and it takes time for the heartbeat to appear. Often the doctor will advice you to repeat the scan after 1 week. However, if the baby measures more 5 mm ( this is called the CRL , or the crown-rump length), and we can't see a heart beat, this suggests the baby is dead. This is called an IUFD, or an intrauterine fetal death ( missed abortion). Read more at http://www.drmalpani.com/early_pregnancy_scans_atlas.htm
The commonest reason for this is a genetic abnormality in the fetus, and this is Nature's defense mechanism, to prevent the birth of an abnormal baby. While these defects are often random, they are commoner in older women. This is because the eggs of older women have more genetically abnormalities, because they have "aged" and have genetic defects, which cannot be screened for.
There is no need to do a D&C for this. This can cause Asherman syndrome ( intrauterine adhesions). Read more at www.drmalpani.com/knowledge-center/articles/asherman. Ask them to terminate it medically with mifegest and misoprostol. There's no point in doing a genetic/ chromosomal study of the fetus/ products of conception, because this provides us with no useful clinically actionable information.
Even if you do miscarry, don't get disheartened. The fact you have conceived in the past ( even though you did miscarry) means your chances of having a healthy baby in the future are excellent.
For most IVF patients, the scans will be normal. We do them to reassure you that all is well, so you can relax and start enjoying their pregnancy. Please add your scan images to your embryo photos in your baby album !
Need help in getting pregnant ? Please send me your medical details by filling in the form at www.drmalpani.com/free-second-opinion so that I can guide you !

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