Early Path Medical Consultation Services

If you are less than seven weeks pregnant and your pregnancy hasn't developed a heartbeat but otherwise seems fine, you could be told your pregnancy is not viable when it is actually healthy. There is a huge range of ultrasound equipment being used in practice, and a great range in the expertise of the folks using the equipment. We don't think hard-and-fast numbers or guideposts are fair to be used by all folks in all places, because your doctor may have newer (or older) equipment, and greater (or lesser) experience with that equipment that allows them to speak with greater (or lesser) authority on when a heart beat is seen, etc. One reason a heartbeat may not be seen, besides the sensitivity of the equipment or the skill of the operator, may be if your pregnancy is at an earlier gestational age than you thought. For example, you may feel certain you conceived on a particular day based on your last period and your presumed time of ovulation but, if you ovulated unexpectedly late in that cycle, you could be several days to weeks off on the gestational age you report to your doctor.

If a fetal heartbeat has been established and then disappears, to be absolutely sure of the diagnosis your doctor may choose to refer you for a second opinion with a different operator, or a different machine. Or he may have you return for a repeat ultrasound. However, if your doctor is confident in the expertise and equipment of the ultrasonographer and is sure the sonographer performed a careful and thorough study that failed to see a heartbeat then your obstetrician will most likely correctly diagnose a missed abortion.

In cases like this your pregnancy hormone levels may continue to rise. If the pregnancy is not viable, these rising hormone levels tend to reflect placental function, which may be normal for as many as several weeks to two months after the death of the fetus. Those hormones may keep you "feeling pregnant" even though the baby is no longer truly "on board".