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Pregnancy Bliss | Reproductive Health Hub

No yolk sac or fetus on the early scan

Question:  I went in on Monday for a sonogram because I had brown discharge the night before only once. By their calculations I am 5.5 weeks along per my LMP. They saw a nice round gestational sac but no yolk sac or baby. The sono tech was very negative about it and got my so upset. My obgyn says to come back on Monday again and get another sono. It is common for it to be too early to show anything? I have two healthy children and only had one mc before my first was ever born almost 10 years ago. I am worrying myself sick over this! M (USA)

Answer: It may be difficult to allay your concerns at this stage. Your pregnancy is just under six weeks gestation calculating from your dates. Normally, a sonogram (scan) should be able to show a fetal pole and a detectable fetal heart pulsation at around this stage of the pregnancy. A yolk sac should also be visible. This might be the reason why the ultrasonographer was not particularly positive when none of these could be seen. It is, of course, possible that the gestation as calculated from your dates is erroneous and the pregnancy isn’t as advanced as suggested by the dates. A repeat scan is therefore the right thing to do and since that is a function of time, there is very little you can do but wait. I hope it turns out well in the end for you so my best wishes.

Traumatic delivery

Question: Hi, I had my baby boy 6 yrs ago and am still wondering and remembering the awful time i had giving birth 2 him i was in labour 4 14 hrs and was not allowed 2 move off my back. I had 2 lie still not move and my baby had probs put on his head he finally came out all bruised on his face and still has the scars from these probs. I wasn't really told why this was and i can’t get it out of my head. I was 13 days over due and had my waters broke 3 times and still lost lots of water. Can u explain plz and put my mind at peace a little? Thank you. F. (UK)


Answer: You clearly have a lot of unanswered questions. I must confess that a lot of what you have described here is rather puzzling and confusing for me. I am not sure what you mean by ‘probs’ that were put on the baby’s head. Do you mean forceps that are used to assist a difficult delivery? If that is so, these should certainly not leave any long term marks on the baby. These can indeed cause bruising (see image below) but those bruises are invariably superficial and should disappear in 2 or 3 days and certainly in less than aforceps bruising week after the birth. If there is scarring from this six years on, that is exceptionally unusual and would require proper explanation. The only place you can get that is the place where the birth took place. I must stress that I do not know of any circumstances where forceps delivery could lead to that extent of trauma.

You have also mentioned that you were told to lie still and not move during labour. This is extremely uncommon and even 6 years ago, such practise was not the norm. You should have been told why you were given such advice. It is always encouraged for the woman in labour to be mobile whenever possible. If you were specifically advised against being mobile there would have been a reason for this and even at this late stage you can and should be told.

Another issue you mentioned is that you had your waters broken “three times”. This is not possible. Waters can only be broken once. It is possible that there were three attempts to break your waters and those attempts were not successful. That is the most plausible explanation for this particular issue.

As I said earlier, there are a number of aspects that are not quite clear here even to me. It is likely that all of them have entirely reasonable explanations but that you never got an opportunity to have a proper debrief. My view therefore is that you should arrange a meeting with the consultant under whose care you were during the pregnancy. This is easily arranged through the hospital’s PALS (Patients Advice and Liaison Service). Best wishes.

Cervical polyp and post-coital bleeding

Question:   Thank you for the this website which is very educative.

I asked a question sometimes ago concerning vaginal bleeding during intercourse and you advised me to see a Gynaecologist which i did and it was discovered through pap smear that it was cervical polyp. I want to update that i had it removed last week. My question now is can i take in again? J.A. (Nigeria)

Answer: Cervical polyps are rather common and, like in your case, they can cause inter-menstrual aand/or post-coital bleeding. The bleeds tend to be light but they are recurrent and a real cause of anxiety. These polyps are almost invariably benign.

Whilst it is uncommon, recurrence does occur for some women and  polypectomy (removal of polyps) may need to be done more than once because of that. In any case, the advice is always to see a doctor for at least an examination whenever you experience abnormal vaginal bleeding. It is a useful precaution that gives you peace of mind and also allows for prompt and timely intervention in case of a more serious problem. This is particularly important for women who live in parts of the world where there are no routine cervical smear screening programs. I am glad to know that everything has turned out well for you. Best wishes.