No fetal pole at 5 weeks should I be worried

I am 6 weeks pregnant. During the 5 weeks 4days gestational pregnancy, i got my internal ultrasound done. There appeared to be only the sack and no fetus pole. I am called again after 2 weeks for ultrasound. I am currently taking folic acid tablet and susten 200. Do i need to take any injections or medicines for the fetus development? I am 34 yrs old. I am worried as my doctor tells me thst its a 50-50 chance for me. I rarely have any nausea or sickness. Please suggest.

Hello..well dear I understand your anxiety about it but then yes if there is no foetal pole then yes we ask them to wait as after 6 the week we will be able assess it properly...you need not have to worry about any more injections or supplement as you are already taking them.. thank you

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An ultrasound is a routine part of prenatal care at six to nine weeks. The ultrasounds we might do prior to that, and the information those exams would reveal, generally occur in four stages:

1. Stage One: If performed around the time a women’s menstrual period is expected, this ultrasound typically shows a fluffy, thick lining of the uterus that’s preparing for the fertilized egg to implant.
2. Stage Two: This is usually at four to five weeks after a pregnant woman’s last period. The ultrasound commonly shows a small collection of fluid within the lining of the uterus that represents the early development of the gestational sac.
3. Stage Three: This is usually about five and a half weeks after a pregnant woman’s last period. The ultrasound typically shows a gestational sac and within it we can see a 3-5 mm bubble-like structure, which is the yolk sac.
4. Stage Four: Approximately six weeks after a pregnant woman’s last period, we can see a small fetal pole, one of the first stages of growth for an embryo, which develops alongside the yolk sac.

While these are the expected times to see the developing pregnancy with an ultrasound, not all pregnancies develop along the same timeline. Just like pregnancy tests, if there’s variability in the length of the menstrual cycle or when fertilization takes place, then what we see on ultrasound can change. It’s important that this ultrasound is performed vaginally for high-quality pictures.

If the first ultrasound doesn’t show a developing baby with a heartbeat, when should the next one be scheduled?

Newly pregnant women get anxious if we don’t see both a fetus and a heartbeat on the first ultrasound and frequently want to come back soon after for another look. But it takes time to move through the early stages of pregnancy. And repeating an ultrasound still won’t be able to reassure the patient that the fetus is alive and growing, if we do it too soon.

The general recommendations are to wait two weeks if we only see a gestational sac and at least 11 days if a gestational and yolk sac are seen without a fetal pole. I prefer to wait two weeks for the next ultrasound in both of these scenarios. If we can see an early fetal pole but can’t see cardiac movement, then we repeat an ultrasound in one week. I know waiting is hard – but in my experience, it is much better to wait and get a definitive report on the status of your pregnancy than potentially have to come back multiple times.

Pregnancy loss can occur during any stage of pregnancy, though it’s most common in the first trimester. If we do an ultrasound and the length of the baby is more than 7mm, we should always see movement of the fetal heart.  If we don’t, we know the pregnancy is not going to develop. 

1) If the pregnancy is very early, the gestation sac may be visible but the baby is still developing. In viable pregnancies, a trans-vaginal (internal) scan should be able to detect a gestation sac from 5weeks of pregnancy. A yolk sac can be seen at 5 1/2 weeks and fetal pole (small embryo) seen at approximately 6 weeks. Ultrasound scans can detect a fetal heartbeat at approximately 6-7 weeks of pregnancy. Trans-abdominal (external) scan may be less accurate at this early stage.

Bhcg (pregnancy hormone) levels should indicate whether or not a sac should be seen. At levels >2000, we would hope to see a gestation sac on ultrasound.

2) A very large gestation sac (average diameter >25mm) With no baby is called an an-embryonic pregnancy (the old term is blighted ovum). Sadly, this is a type of miscarriage when a very early embryo stops developing. The cause is unknown. The placenta and gestation sac can continue to support itself for a short time and will continue to produce Bhcg. Therefore, pregnancy symptoms and positive pregnancy tests will continue, even though the pregnancy is failing. You may suffer pain or bleeding or it can happen with no symptoms.

3) Very rarely an empty sac can be associated with ectopic pregnancy (pregnancy implanted outside the womb). This is a dangerous complication of pregnancy requiring hospital treatment. If your sonographer is concerned, they will discuss this with you.

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Peek-A-Baby! Is Your Local Family Run Clinic That Has Been Providing Scans For Many Years - We Are Not A Franchise How late can a fetal pole develop?

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