Why Can't I See My Baby on Ultrasound During Early Pregnancy?

I am pregnant, but the abdominal ultrasound does not show anything yet?

Last month, my period started on March 10, with a cycle of about 21 days.
On April 10, I experienced pain in my lower left abdomen, and my period was also delayed.
I went to a gynecology clinic for an examination and confirmed that I was pregnant.
An abdominal ultrasound was performed that day, but nothing was visible.
The doctor advised me to have another ultrasound on the 17th, and again, nothing was visible.
I took another pregnancy test, which also confirmed the pregnancy.
The doctor said I need to be monitored.
Is this situation normal? As a first-time mom, I am very worried that this might not be a normal pregnancy...

Niming, 20~29 year old female. Ask Date: 2017/04/18

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last month, my period started on March 10, with a cycle of about 21 days.
On April 10, I experienced pain in my lower left abdomen, and my period was also late.
I went to a gynecology clinic for an examination and confirmed that I was pregnant.
An abdominal ultrasound was performed that day, but nothing was visible.
The doctor advised me to have another ultrasound on the 17th, but again nothing was seen.
I took another pregnancy test, which also confirmed the pregnancy.
The doctor said I need to be monitored.
Is this situation normal?
Answer: It is advisable to measure beta-hCG levels twice for differential diagnosis.

Reply Date: 2017/04/18

More Info

In early pregnancy, particularly around the time of your missed period, it is not uncommon for an ultrasound to fail to show a developing fetus. This can be concerning for many expectant mothers, especially if they are new to pregnancy and unsure of what to expect.
The first thing to understand is that during the early stages of pregnancy, typically around 4 to 5 weeks, the embryo is still very small and may not be easily visible on an abdominal ultrasound. At this stage, what is often seen is the gestational sac, which is a fluid-filled structure that surrounds the developing embryo. The fetal pole, which is the part of the embryo that will eventually develop into the fetus, usually becomes visible around 6 weeks of gestation. If you are not seeing the fetal pole by this time, it can be a cause for concern, but it is not always indicative of a problem.

In your case, since your last menstrual period was on March 10 and you experienced abdominal pain on April 10, it is likely that you were around 4 weeks pregnant at the time of your first ultrasound. At this early stage, it is possible that the embryo was simply too small to be detected. The doctor’s recommendation to return for a follow-up ultrasound is standard practice. This allows for monitoring of the pregnancy as it progresses.
If you returned for another ultrasound on April 17 and still did not see the fetal pole, it could mean a few things. One possibility is that the pregnancy is not developing normally, which could lead to a miscarriage. However, it is also possible that the timing of the ultrasound was just too early to see the fetal pole. The gestational age calculated from your last menstrual period may not accurately reflect the actual development of the embryo, especially if your cycle is irregular or shorter than average.

It is essential to keep in mind that every pregnancy is unique. Factors such as the timing of ovulation, the implantation of the embryo, and individual variations in development can all influence what is visible on an ultrasound. If the doctor has confirmed that you are pregnant through a urine or blood test, it is a positive sign, but the ultrasound may take a little longer to catch up.

If you are feeling anxious about the situation, it is important to communicate your concerns with your healthcare provider. They can provide reassurance and explain the reasons for the follow-up ultrasounds. Additionally, they may suggest monitoring your hormone levels through blood tests, which can provide further information about the viability of the pregnancy.

In summary, not seeing your baby on an ultrasound during early pregnancy can be normal, especially if the ultrasound is performed too early. It is crucial to follow up with your healthcare provider and continue monitoring the situation. Trust in the process, and remember that many women experience similar uncertainties during early pregnancy. Your healthcare team is there to support you and ensure the best possible outcome for you and your baby.

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