Early Pregnancy Ultrasound: No Heartbeat at 6 Weeks 5 Days

At 6 weeks and 5 days of gestation, no heartbeat was detected?

Hello, doctor.
I would like to ask about my current pregnancy status.
I am 6 weeks and 5 days pregnant.
Today, I went for a follow-up ultrasound, but we couldn't detect the baby's heartbeat.
The doctor mentioned that under normal circumstances, we should be able to see it by now and suggested that I come back in a few days for another ultrasound.
If we still don't see it, we may need to consider surgery.
However, the embryo's CRL is 0.79 cm, indicating that it is still growing and not shrinking.
I also mentioned that I have been experiencing occasional vaginal itching with yellowish-white cheesy discharge.
The doctor responded that it might be bleeding, but I believe it is likely a common occurrence of vaginal inflammation during pregnancy.
If it were bleeding, shouldn't it be brownish in color? I found online that many mothers only detected the heartbeat around 8 weeks or even later.
Should I consider switching clinics, or would it be better to wait a bit longer for a follow-up? Thank you.

Oli, 20~29 year old female. Ask Date: 2019/06/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I am currently 6 weeks and 5 days pregnant.
Today, I went for a follow-up appointment for an ultrasound, but we couldn't detect the baby's heartbeat.
The doctor mentioned that normally we should be able to see it at this stage and suggested that if we don't see it in a few days, we may need to consider surgery.
However, the embryo's CRL is 0.79 cm, indicating that it is still growing and not shrinking.
I also told him that I have been experiencing some vaginal itching and yellowish-white cottage cheese-like discharge.
He responded that it might be bleeding, but I believe it is more likely to be a common occurrence of vaginal inflammation during pregnancy.
If it were bleeding, shouldn't it be brown? I have read online that many mothers only saw the heartbeat at 8 weeks or even later.
Should I consider switching clinics, or is it better to wait a bit longer for a follow-up appointment? Answer: Return for another ultrasound next week.

Reply Date: 2019/06/02

More Info

When it comes to early pregnancy ultrasounds, the absence of a detectable fetal heartbeat at 6 weeks and 5 days can be concerning for many expectant mothers. However, it's important to understand that this situation can occur for several reasons, and not all of them indicate a problem with the pregnancy.

At 6 weeks and 5 days, the embryo is still very small, and the development of the heart and its ability to be detected via ultrasound can vary significantly from one pregnancy to another. The Crown-Rump Length (CRL) of 0.79 cm suggests that the embryo is growing, which is a positive sign. Typically, a fetal heartbeat can often be detected by transvaginal ultrasound around 6 to 7 weeks of gestation, but this can vary based on several factors, including the position of the embryo, the quality of the ultrasound equipment, and the technician's experience.

Your doctor’s recommendation to return for another ultrasound in a few days is standard practice. This follow-up is crucial because it allows for monitoring of the embryo's growth and development. If the embryo continues to grow and a heartbeat is detected at that time, it would indicate a healthy progression of the pregnancy. Conversely, if there is no growth or a heartbeat is still absent, further evaluation may be necessary to determine the next steps.

Regarding the vaginal symptoms you mentioned, such as itching and the presence of yellow-white discharge, these could indeed be signs of a common condition like a yeast infection, which is not uncommon during pregnancy due to hormonal changes. However, if there is any bleeding, especially if it is bright red or accompanied by cramping, it is essential to seek medical attention immediately. Brown discharge can sometimes be normal, but any new or concerning symptoms should be discussed with your healthcare provider.

If you feel uncertain about your current doctor's assessment or if you are experiencing anxiety about the situation, it is entirely reasonable to seek a second opinion. Different practitioners may have varying approaches and insights, which can provide you with additional reassurance or alternative options for care.

In summary, while the absence of a heartbeat at this stage can be worrisome, it is not uncommon, and many pregnancies progress normally after similar findings. Monitoring the situation with follow-up ultrasounds is essential, and addressing any symptoms you are experiencing with your healthcare provider is crucial for your peace of mind and health. Remember, every pregnancy is unique, and staying informed and proactive about your health is the best approach.

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