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Query about pregnancy and estimation of exact dates.

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In June of last year (2013), I met my current girlfriend and we had our first sex on July 4th. She stayed with me until around July 8th. We didn't see each other until one week later she called me to say that she realized the days she visited me were her fertile period. She said she suspected she might have been pregnant and few days after that (I can't remember how many days after that), she had a home pregnancy test that came out positive. On July 22nd, she had what she called a routine gynecologist appointment, but somehow, the doctor ordered that she does a sonogram (I assume it was transvaginal). She did this on July 24th. When she picked up the results a week later she called me and told me that the sonogram showed that the "fetus" measured 9mm. When I checked the measurement online, I thought it was odd and asked her. She claimed that she too thought it was odd, but that her doctor said it was ok. Now, I realized later that I don't know what she meant by "fetus", but I really thought that time was too early for the sonogram to pick up anything that measured 9mm. For most of her pregnancy, she claimed that the fetus had measurements that matched exactly the week she was in. But in her 32nd week, she told me that the doctor found the head circumference measuring at 35 weeks.
Am I wrong in suspecting that these measurements do not make sense? Is there a way that the measurement on July 24th could've been 9mm? And is there a way a fetus head circumference can measure 28 weeks at 28 weeks and then 35 weeks at 32 weeks? Please help.

Category: OBGYN

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Category: Infertility Specialist
 28 Doctors Online

Hello,
Thanks for writing to DoctorSpring with your health concern.

If she conceived between July 4 - 8th, she would be around 5 weeks on the 24th of July, when the scan was done ( weeks are calculated not from day of conception but from day of her last menstrual period, which I am assuming was 2 weeks prior to the fertile period, which is generally midcycle ).

If you could tell me the date of her last menstrual period, that would be more helpful.

Next, around 5 weeks, the foetus is generally not seen, it is too early.
What would be seen would be the gestational sac ( the pregnancy sac ).
This can measure 9 mm at around 5 weeks, so that tallies.

Generally a head which corresponds to gestational age at 28 weeks, would not measure 3 weeks more at 35 weeks.
However, third trimester scans are most unreliable in dating.

If the first scan corresponds to around 5 weeks, chances are high she conceived around July 4 - 8th, provided she had regular cycles.

All the best
Hope this helped you.
Please feel free to discuss further.


Patient replied :

Hello,

Thanks for a prompt answer. This was very helpful! I have tried to ignore the matter, but some of the things I heard and especially the measurements at 32 weeks made me shake a little.

I have attached a picture of when that first sonogram in question was done. This is a picture she took with her phone from the computer when, she told me, the lady who was taking the sonogram stepped out (I just removed her identifying info). It says that her LMP was 6/27/2013. She has never shown me the results of that sonogram or any more pictures from it. After I saw that picture, I asked her if her due date was April 3rd. She did not comment on that immediately, but later on, she told me that her due date was on March 31st which could mean that she may have changed the LMP to be 6/24/2013. Later on, she changed her ObyGyn and according to her, her new obyGyn confirmed the March 31st date. So, I've used the range (6/24 - 6/27) in my calculations giving her the benefit of the doubt that she could have made a mistake in stating the initial 6/27 date.

Thank you.

Gustave


Hello
The image sent across is essentially of no use.
I need to have the zoomed in scans and the printed reports.
Just a snap taken from the phone will not help.
And considering her LMP to be 24th Of june, she could have ovulated by the 8th of July and then what she says make sense.
Ask her to get the printed sonogram report done on the 24th of July.
That might help more.
Take care
Thankyou


Patient replied :

HelloThe image sent across is essentially of no use.I need to have the zoomed in scans and the printed reports.Just a snap taken from the phone will not help. And considering her LMP to be 24th Of june, she could have ovulated by the 8th of July and then what she says make sense.Ask her to get the printed sonogram report done on the 24th of July.That might be of more help.Take care. Thankyou


Thank you. I'll check if I can get a full printed report, but I have confirmed from the CD she got that the sonogram on the July 24th says that her LMP was on June 27th (looking at the CD report she got). Would that change anything especially in terms of measurements? I'm still afraid of asking her if she'd changed her LMP to be June 24th and for what reason if indeed she changed it.


Thanks.


Patient replied :

Changing the LMP by a few days ( 3 days in this case does not matter ) because early trimester scans also have an error margin of 5 - 7 days, so do not worry that her changing the LMP will affect the interpretation.
Once I have the scan in hand ( or the report ) I will be able to be more specific with you.
Good day !



Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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