Hello,
Thank you for asking your query at DoctorSpring.com.
From your description I understand that you assumed that your pregnancy to be 5 weeks old, but now concerned it is more than 5 weeks, because you are not sure about the last menstrual period, whether it was menstrual bleeding at all.
Now even in that case, I should say the gestational age is corresponding to the ultrasound. Heart beats are usually visible only by 7-8 weeks of pregnancy. A discrepancy of one or two weeks may be considered within normal limits. So your ultrasound is more or less on ‘target’ and there is no need for any concern regarding that as of now.
I understand that you have been exposed to alchol, xray, physical strain, drugs etc during early pregnancy. While these are considered risky and bad for the growing fetus it’s not necessary that it should do some damage always. Most of the time the baby will be safe and you just need to take precautions here after. Incase you do not want to continue with the pregnancy I recommend you to go ahead and discuss it with your Doctor (Ofcourse as per your religious / ethical and legal views). You should decide, after discussion with your partner whether you should go ahead with the pregnancy and then take an informed decision.
Patient replied :
Is it likely or unlikely the baby suffered symmetrical iugr? The crown rump length measured 6 weeks 3 days and heartbeat is 111. Based on my last normal period, the ultrasound would be measuring 2 and 1/2 weeks behind the gestational age.
Hello,
To help you with your queries, can you provide me with the following information :
1.Last date of bleeding per Vagina , and how it was different from your normal menstrual bleed.
2.LMP (Last menstrual period) -
3.Date of the USG -
4.Your normal menstrual cycle duration and length -
Thank you.
Patient replied :
1. Start of last vaginal bleeding was Jan 6. Brown spotting on the 7 then it stopped. On the 8 brown blood with tissue-like material then bright red blood with clots for two days and then brown spotting. It was different because the flow was not as heavy and it did not last as long.
2. Dec. 9 was date of last normal period.
3. Ultrasound was Feb 13.
4. Normal cycle is 5-6 days with heavy flow.
Hello,
Thank your reply.
If you consider Jan 6 as the LMP, then the gestational age by menstrual period is corresponding to the the Crown rump length. If Dec9 is considered then there is 3 weeks lag. Now I want you to understand that CRL (Crown rump length) comes useful typically in these kind of situations. When there is doubt regarding the LMP, you go for CRL measurement. CRL measurement gives you the accurate gestational age of the fetus.
Now coming to IUGR. This found out by measuring certain other parameters via USG (and some times blood sampling) and then comparing it with a normal fetus of corresponding CRL. If you are concerned about IUGR, I would recommend you to visit a specialist in prenatal USG/Doppler and seek further advice. As of now there is nothing to suggest the baby has IUGR. As I said earlier, it is premature to comment on IUGR and growth.
Hope this helps.
All the best wishes.
Patient replied :
Since CRL and heart rate of 111 both correspond to gestational age of six weeks, is it more likely GA is six weeks? Also, I went to dr yesterday for ultrasound and baby's growth rate was normal and heart rate was 156. Dr said she isn't worried. If there was iugr in the beginning to cause a three week lag, would the growth rate typically continue to lag?
Hello,
Yes, the Gestational age by CRL is more accurate, that is 6 weeks. There is nothing to suggest a IUGR of 3 weeks as you say so there is not question of lag i guess.
Hope this helps.