Reply To Jess

Jess said :

dear Doctor,

I have a strong positive line of my urine test but no sac being found from the ultrasound scanning this morning.Would it be too early to detect the sac.My last menses is on 25/07/09 and provided that i have an irregular menses cycle for where it can be delayed about two weeks times. so it's hard for me to tell exactly when is my last ovulation date.

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Hi! Jess,

We are dealing with a few possibilities here:

1) Based on your Last Menses Date of 25/7/2009, currently you are pregnant at 7 weeks gestation. The pregnancy sac should be seen by ultrasound at this stage of pregnancy.However, due to your irregular menses cycle, your pregnancy may be delayed due to delay in ovulation.It means you may be pregnant at the very beginning stage. The pregnancy sac is difficult to detect by ultrasound if it is less than 6 weeks.

2) You may have a failed pregnancy where the sac fails to develop. As a result, it was not seen by the scan. Miscarriage is a common problem during early stage of pregnancy. 10% to 20% of the women actually suffer from miscarriage during early stage of pregnancy.

3) If the sac is not located inside the uterus, then it may be located at the outside the uterus. We call this condition ectopic pregnancy.

Pregnancy sac in Fallopian tube

So.. Jess, how to know you belong to which possibility ?

1) In a normal pregnancy, the symptoms of pregnancy will appear by now. Among the symptoms of pregnancy are vomiting, dizziness, breast pain and lost of appetize.If your pregnancy is a failed pregnancy, this symptoms will not appear.



2) If this pregnancy is an ectopic pregnancy, usually you will suffer from abdominal pain and bleeding from vagina.


What should you do now ?


Well, you have a few options in this situation:

1) Wait for 1 week and repeat the scan after 1 week. If your pregnancy is healthy and located inside the uterus, you should able to see it after 1 week.

2) If your are very worried and you want to know the answer now, the doctor can perform a vaginal scan which produce a clearer image. In vaginal scan, the sac can be seen as early as 5 weeks pregnancy.




3) Blood test to measure the pregnancy hormone level (beta HCG). This test is useful to early diagnose ectopic pregnancy.



Anyway, I wish you best luck in your subsequent follow up with your doctor.



Cheers!