What to do if there is no fetal heartbeat at 10 weeks?

Question

Hi doctor,

I have not had a period and have been testing positive for pregnancy. I went to Urgent Care this week and got a blood test. The doctor called me to confirm that I should be 8-10 weeks pregnant. I went to Planned Parenthood for an ultrasound yesterday, and we only saw a gestational sac and nothing else. I had more blood work done, and a doctor called me today to say that my HCG levels are over 32,000 and my pregnancy is not viable.

I need to schedule a surgical procedure, as this could be a molar pregnancy or a blighted ovum. I feel very, very sick with pregnancy symptoms (nausea, extreme fatigue, breast tenderness, headaches, etc.). I called back to schedule a D and C, and they said the earliest they could see me would be five days from now. I am worried. Should I go to the hospital immediately?

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

The diagnosis of a blighted ovum or molar pregnancy can be easily confirmed on the scan. If in doubt, an MRI can confirm the diagnosis. It is not a healthy pregnancy, as by 5-6 weeks, any pregnancy will be seen, and also the cardiac pulsation. So at HCG of 32000, a sac with the fetal heart will be seen. If this is a blighted ovum, it is not an emergency. You can wait for five days and get it removed. But a more natural method would be the use of Mifepristone 200 mg, two tablets orally and vaginally, and after 48 hours, take four tablets of Misoprostol 200 mcg. You will bleed and have periods like a regular one. A surgical evacuation will not be needed. But if this is a molar pregnancy, it is like an emergency. As time passes, the beta hCG will rise. Your blood level of hCG will increase and reduce the hemoglobin level, which will result in giddiness, vomiting, and nausea. You need to arrange a blood donor and have a vacuum evacuation under anesthesia. So I would advise that you should confirm the diagnosis and do the needful. Do not get stressed out; you will be fine. It is not a life-threatening condition.

I hope this information helps you.

Feel free to ask further queries.

Thank you.