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Why doesn’t my ultrasound show any cardiac activity of the fetus?

Q: I am a 28 years old pregnant woman and according to the transabdominal ultrasound done last month, the fetus is six weeks and five days old. I had my last periods two months back, according to which I should be in the 8th week of pregnancy. However, it is not so. Also, yesterday's ultrasound did not show any cardiac activity. Fetal pole is seen and the crown-rump length (CRL) is 7.6 mm. Is it a matter of concern? I am a bit worried about the baby's growth. The sonologist has asked to come back after a week to check for cardiac activity. Does this usually happen? To add, I was on infertility treatment before I conceived.

A:Yes, the treatment is correct. A repeat transvaginal scan will give all the details of fetal size, heart rate and sac volume and CRL. If all is normal no further treatment is necessary except rest and care of diet. If the heart rate is absent, then it maybe a missed abortion due to some fetal defect- and abortion needs to be carried out- with medicine available these days to do so- misoprostol and miphipristone. You will later need to undergo tests to find cause for the abortion and pre-pregnancy testing to treat the cause, if found. A gap of 6 months too will be needed before planning the next pregnancy.

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