Why does the ultrasound not show pregnancy, but the test results are opposite? Why the ovary is not visible on the ultrasound Could the embryo not be seen on the ultrasound

"Why doesn't ultrasound show pregnancy?" - Parents are often worried if blood and urine tests before this confirmed the fact of conception. This can be caused by many reasons. When the pregnancy test is positive, and the ultrasound does not show pregnancy, most likely the time of conception was set incorrectly, and the parents made the diagnosis too early. But it also happens that a blood and urine test shows pregnancy, when in reality it is not. This is a very serious signal and may indicate the development of a malignant tumor that produces substances characteristic of a fertilized egg.

The first test that helps determine the presence of pregnancy is a blood and urine test for hCG (chorionic gonadotropin). Reagents aimed at determining this substance are applied to the test strips that women use to find out if conception has occurred. The test data is confirmed by a blood test for the determination of the same hormone. Why this is so is explained as follows.

When the egg is fertilized, the developing embryo begins to move towards the uterus and attaches to its mucosa 4-12 days after ovulation. This is called egg implantation. After that, trophoblasts (cells of the outer layer of the embryo) begin to produce hCG. The production of this hormone in the first 8-10 weeks of pregnancy increases at a very high rate, doubling every 2 days. But in order to be detected in the blood or urine, several days must pass after the implantation of the embryo. Therefore, the definition of pregnancy primarily depends on how quickly implantation occurs.

The concentration of hCG in the urine is almost always less than in the blood, and also largely depends on the amount of liquid consumed. If a pregnant woman consumes a lot of water, the concentration of the hormone in the urine will be greatly diluted. This is one of the reasons why it is better to take the morning portion of urine for analysis: at this time, urine has the highest concentration, since people do not drink during sleep.

Unlike urine, fluid content in the blood is more strictly regulated and remains almost unchanged even if a woman drinks a lot. Therefore, a blood test can detect pregnancy much earlier than a urine test.

How accurate are blood and urine tests?

Another point to consider during a pregnancy test is what method is used to determine hCG, qualitative or quantitative. Qualitative tests are those that can be bought without a prescription at a pharmacy to determine hCG in the urine. The sensitivity of these tests usually prevents them from detecting levels below 20-50 IU/L. In addition, the reliability of the test depends largely on its manufacturer. It happens that you can buy a pregnancy test with a sensitivity that is much higher than the tests used in clinics.

Quantitative hCG tests are performed on blood samples in laboratories. These assays are highly sensitive and allow you to see the amount of hCG from 0.1 to 2 IU/L, depending on the equipment used. Therefore, quantitative methods allow you to determine pregnancy a few days earlier than qualitative ones.

During testing, the correct results are considered to be tests made a week after the delay. However, given the increase in hCG, the correct data can be obtained as early as three days before the expected day of menstruation. Since pregnancy occurs during ovulation, that is, in the middle of the menstrual cycle, the period between conception and delay is 14 days with a 28 day cycle. By this time, the fetal egg has time to reach the uterus and gain a foothold in it. However, on the eleventh day after fertilization (i.e. 3 days before menstruation), hCG is not always detected, which depends on the individual characteristics of the organism.

Pathological causes of hCG growth

Despite the foregoing, a positive hCG test value does not always mean that the egg has been fertilized. The situation when the test is positive on ultrasound is not visible, is also possible for pathological reasons.

For example, it can be a biochemical pregnancy. This is the name of the condition when a pregnant woman loses the fetus even before the expected menstruation. If the test for hCG is done after the loss of the fetus, but before this hormone is excreted from the body during metabolism, the test may show a positive result.

Biochemical pregnancy is not as rare as it might seem at first glance. A woman in such a situation often confuses a miscarriage with regular periods, which are simply accompanied by more painful symptoms.

Another cause of elevated hCG is the pituitary gland, the endocrine gland of the brain, which controls the production of almost all hormones in the body. Including, it can produce hCG. It is worth noting that some hormones produced by the pituitary gland (stimulating the thyroid gland, ovaries and luteinizing hormone) are structurally very similar to hCG.

The presence of hCG in the body due to the synthesis of this hormone by the pituitary gland is more often determined in women over 55 years old, but can sometimes be determined in women over 41 years old. However, its number in the body is small, so the important point is that the concentration of hCG produced by the pituitary gland does not increase to the same extent as it does during pregnancy.

Some malignant tumors can also synthesize hCG in large quantities. Most often, these are cancer cells that develop in the reproductive system, for example, chariocarcinoma. In such cases, there is no pregnancy, and the test is positive. Therefore, ultrasound is not mistaken.

In some, antibodies appear in the blood that can be mistaken for hCG, and therefore, after the test, women think that they are pregnant, but in reality there is no pregnancy. Only blood tests are subject to these errors, since these antibodies do not enter the urine. This phenomenon can be a serious problem, as it can lead to misdiagnosis, as doctors can be wrong based on erroneous data.

It happens that women are misdiagnosed with cancer due to a false positive hCG test. It is even worse when, on the basis of a false analysis, surgery, chemotherapy or other invasive treatments are performed, which are absolutely not needed. The reason for this phenomenon is often impossible to establish. Mistakes can be avoided by conducting analysis in several reputable laboratories.

Based on the foregoing, it becomes clear why, based on the results of a positive hCG analysis alone, it is impossible to determine whether a woman is pregnant or not.

Therefore, if the test for hCG showed pregnancy, it will be necessary to undergo other tests. One of these tests is an ultrasound examination. And if it happens that the test shows pregnancy, but the ultrasound does not, the question arises: “Can an ultrasound not show pregnancy?”

What is ultrasound

It is desirable that an ultrasound be performed by a qualified professional who could detect a deviation in the development of the child in time. If it happened that the test showed pregnancy, but the fetal egg was not seen on the ultrasound, such a doctor must understand how to proceed.

During the examination, the radiologist applies some special gel to the pregnant woman's abdomen and moves the transmitter from side to side, capturing the best images of the fetus. While preparing for an ultrasound at an early stage of pregnancy, you should drink several glasses of water before the procedure. A full bladder helps make the best images of the fetus.

When ultrasound waves pass through the uterus of a pregnant woman, if there is a fetus, they detect it and are reflected from the embryo and tissues of the woman, like an echo. These echoes are converted into an image on a screen that shows the position of the fetus in the uterus and its movements.

Hard tissues, such as bones, produce stronger echoes, which are white on the screen of the ultrasound machine. When an ultrasound detects a gestational sac, the softer tissues take on shades of grey. Amniotic fluid and other fluids are black on the screen because the ultrasound passes through them with little to no reflection. When interpreting the image obtained during the examination, the doctor deciphers these images, visible as transitions of halftones of white and black.

If the baby is deep in the pelvis or the pregnant woman is overweight, the woman is offered a transvaginal ultrasound. This study is carried out by inserting a lubricated probe into the vagina and performing an internal ultrasound. The method is used when the fetus is too small to be seen on conventional ultrasound. A transvaginal ultrasound can detect an embryo or gestational sac up to a week earlier than a conventional scan.

Why do ultrasound

The first ultrasound, on which the fetus is viewed and visible, can be a very exciting event for a pregnant woman. The radiologist who performs this procedure can even print and give the pregnant woman a photo of the embryo as a keepsake for a certain amount. However, the woman must understand that the purpose of this procedure is not to photograph, but to determine the following parameters:

• Confirmation of a live or missed pregnancy.
• Check the baby's heartbeat.
• Say how many embryos a pregnant woman has.
• Define an ectopic pregnancy.
• Find the cause of bleeding in a pregnant woman.
• Find the exact start date of pregnancy by measuring the fetus.
• Assess the risk of a baby developing Down's syndrome by measuring fluid in the baby's neck at 11 weeks of gestation.
• Clarify the reasons for the deviation of the blood test from the norm.
• Show the position of the baby in the uterus to detect abnormalities.
• Check if the internal organs of the fetus are functioning normally.
• Diagnose various developmental anomalies.
• Assess the amount of amniotic fluid in a pregnant woman and find the location of the placenta.
• Measure the child's growth rate over several scans.

During the first trimester, ultrasound allows you to see the baby's heartbeats, as well as to examine the basic characteristics of the structure of the head, abdominal wall and limbs. The sex of the child can be determined no earlier than 14 weeks, and then on very good equipment. More precisely, this can be understood at week 18.

Determination of the gestational sac on ultrasound

The gestational or yolk sac is visible on ultrasound earlier than the embryo: it is visible as early as the fifth week after fertilization. And it is its presence that confirms or refutes the diagnosis. The yolk sac is an extra-embryonic organ that is formed at the beginning of pregnancy, is a source of nutrients for the fetus, and is actively involved in respiratory processes. Here, erythrocytes, capillaries are formed, from which the baby's circulatory system will subsequently develop. Also, germ cells form on the walls of the yolk sac, on which the sex of the child subsequently depends. Performs a bag and the role of the liver, retaining dangerous toxins.

Thus, the life of the fetus is largely dependent on the gestational sac. But when three months later the placenta and the embryo are formed, the need for it disappears. Therefore, its tissues disintegrate, and at the end of pregnancy it is transformed into a small cyst in the navel.

The answer to why the gestational sac is not visible on ultrasound in case of pregnancy may mean late ovulation in a pregnant woman, which is why the conception date is set incorrectly. Therefore, the answer to the question of whether ultrasound can make a mistake is positive in this case. Therefore, with an hCG level of not more than 1100, ultrasound is re-assigned after a few days.

If the hCG level is more than 1100, but the gestational sac is not visible, this may be a sign of an ectopic or ectopic pregnancy. Unfortunately, in such cases, the fetus almost always dies, and in order to save the life of a woman, an abortion must be performed, otherwise the embryo will rupture the fallopian tubes as it grows (it is to them that it attaches most often during ectopic pregnancy). Therefore, if the ultrasound did not show pregnancy, and the test is positive, it is imperative to check whether an ectopic pregnancy is developing.

The fruit is not visible, what's next?

The embryo can be seen on ultrasound no earlier than the sixth week of pregnancy. To see it, you need to wait this time. But you should be aware that if the gestational age was set incorrectly (the doctor decided that the pregnancy had come earlier), the fetus may not be detected. In this case, the answer to the question is positive, can ultrasound not see the pregnancy. You should also be aware that the first signs of the initial development of the embryo in terms of how the fetal egg looks, become visible on ultrasound no earlier than the eighth week of pregnancy.

If the fetus or gestational sac is not visible on ultrasound, you can try to do an analysis in another laboratory equipped with more powerful and modern ultrasound equipment, since an ultrasound error during pregnancy is possible in the early stages. Another option is to come back for another test in a few days. In the presence of pregnancy, the fetus by this time will be fixed in the uterus and begin to grow.

If pregnancy is not to blame for the increase in hCG, an additional examination is necessary. There is a high probability that a tumor or other pathology develops in the body.

Ultrasound diagnostics has been used for many years. This is the most common research method, because it allows you to quickly identify the largest amount of pathologies. However, even such a modern method as ultrasound diagnostics is imperfect. Today we will consider what ultrasound sees and does not see in gynecology and why.

Ultrasound in gynecology: what determines the effectiveness of the examination and why an ultrasound examination is prescribed first

With the help of ultrasound, the size of the organ, its structure, density, the presence of neoplasms and even their nature (stones, cysts, tumors, seals) are determined. But on condition that the examination is carried out by the correct, expert apparatus.

A typical inexpensive 2D machine used in most hospitals and clinics is perfectly accurate in about 40% of diagnoses. More advanced 3D-devices, when examining pregnant women, reveal up to 90% of malformations. But in any case, 10% of unidentified pathologies remain, the timely detection of which sometimes affects a person’s life.

Given this, a knowledgeable doctor, in any doubtful case, prescribes additional diagnostics. Sometimes the examination is carried out in parallel. This begs the question, why is it impossible to undergo a more complex examination immediately, bypassing ultrasound?

The answer is unlikely to please you. Of all the instrumental techniques, only ultrasound is completely safe for human health. In addition, it ideally reveals concomitant pathologies. It's also the cheapest method. And no matter how much you are convinced that x-rays are safe, not a single doctor will refer a patient to such a diagnosis several times in a row.

Ultrasound in gynecology: what reveals and what is not able to detect

Sooner or later, any, even the healthiest woman, will have to undergo an ultrasound scan, because this technique is a mandatory examination option during pregnancy. With the help of a 3D ultrasound device, you can see your baby in real time, examine the arms and legs, see him in motion and hear the heartbeat.

What does ultrasound show in early pregnancy?

Ultrasound during pregnancy reveals:

• The presence and nature of pregnancy, duration, starting parameters of development.It is very important not to miss the first ultrasound for a period of 10-11 weeks. It was then that the exact date of birth can be calculated from the height and weight of the child. Also, these data will help in the future to monitor the correct development of the baby. At later dates, errors are observed that interfere with the establishment of the exact date of delivery.
• Gender of the child. It is also important that parents long before the birth of the baby find out what gender he will be born: a boy or a girl. The reproductive organs of the fetus are in fact formed as early as 15 weeks, but it is still difficult to determine the sex of the child on ultrasound during the period of 12-15 weeks. The loop of the umbilical cord can be mistaken for the penis, and the swollen labia of the baby in utero can be mistaken for the scrotum. The optimal term for sex determination is 20-25 weeks. But even in this case, there is a possibility of an error if the baby is uncomfortable for the doctor. The accuracy of gender identification depends on the quality of the equipment and the qualifications of the specialist.

Errors on ultrasound of pregnant women in the early stages

Despite the incredible popularity of ultrasound in the diagnosis of pregnancy, the method does not always give a perfectly accurate result:

• Presence of pregnancy. Up to 5 weeks, it is almost impossible to see the embryo in the uterus. An inexperienced specialist is able to confuse a fetal egg, and its size is only 1.8 cm during this period, with endometrial polyps and vice versa. For up to 3 weeks, it is generally difficult to talk about any pregnancy. A woman may have a spontaneous abortion without even knowing she is pregnant, mistaking the bleeding for her period. Ultrasound in this case will diverge from the results of the express test, which will show two strips. In this case, it is recommended to undergo a second ultrasound within two weeks. If there is inflammation, the walls of the uterus swell, and the doctor takes this for the onset of pregnancy.
• Fetal pathologies. The bicornuate uterus misleads the doctor, and he sees on the monitor screen the absence of a limb in the fetus.
• The number of fruits.Mistakes in the detection of multiple pregnancies are not uncommon. If the embryos are located in the same fetal sac, and the embryos are wrapped around the umbilical cord, the doctor sees only one fetal egg during the examination.
• Ectopic pregnancy. Sometimes it happens that the fetal egg enters the uterus, and the embryo itself is attached to one of the appendages. The doctor, having discovered the pregnancy, may not see the embryo. The woman is calm and confident that the pregnancy is developing normally, and only severe bleeding and sharp pain indicate a pathology. In such a situation, an accurate diagnosis is made only by a transvaginal probe (through the vagina), and not by an abdominal one (through the abdominal wall).

What does ultrasound show in the last stages of pregnancy

The most informative for ultrasound diagnostics is the third trimester of pregnancy. The study reveals the following pathologies of fetal development:

• A multiple pregnancy is determined, two different heartbeats of different frequencies are heard;
• The entanglement of the neck of the fetus with the umbilical cord is diagnosed;
• It is revealed how the umbilical cord is attached, and in case of low attachment, appropriate treatment is prescribed;
• The size of the fetus is determined, hypo- or hypertrophy is diagnosed (not large enough or too large fetus);
• Oxygen deficiency is detected (by the head thrown back);
• The position of the fetus in the uterus, the state of the placenta before childbirth is established;

Ultrasound diagnostics does not guarantee 100% accurate information. A lot depends on the apparatus on which the examination is carried out, and the experience of the uzist. The combination of two factors, human and technical, guarantee reliable results.

Ultrasound errors in determining missed pregnancy

Missed pregnancy occurs for various reasons: genetic abnormalities of the fetus, latent infections in the expectant mother, hormonal disorders, etc. Whatever the reason, for a woman it is always a terrible blow.

A stop in the development of the fetus occurs for up to 28 weeks. The most favorable outcome is when a woman has a spontaneous miscarriage. It is much more dangerous when the fetus stops developing for a period of 14 weeks or more. In a woman, intoxication of the body begins, the body temperature rises, severe bleeding begins. The worst thing in this situation is sepsis (blood poisoning). If the fetus that is frozen in development is not removed in time, inflammation of the uterus begins, which in special cases is removed. Sometimes a woman's blood clotting is disturbed due to intoxication, and death occurs.

There are two characteristic signs of a missed pregnancy: the absence of an embryo in the fetal egg in the early stages and the absence of a heartbeat in the fetus after 7 weeks.

For up to 7 weeks on ultrasound, the doctor sees:

• no signs that the embryo is in the fetal egg;
• the diameter of the fetal egg is not more than 2 mm (at a rate of 4-6 mm);
• fuzzy contours and blurry echostructure of the fetal egg (normal - hyperchoic contours with a hypoechoic center);
• oligohydramnios;
• displacement of the bones of the skull relative to each other;
• the size of the uterus does not correspond to the gestational age;
• no signs of pregnancy.

At a later date, the following violations are visible:

• the size of the embryo from the coccyx to the crown of the head is not more than 7 mm without tracking the heartbeat;
• no heartbeat in the fetus and on re-examination.

To determine a non-developing pregnancy only by the absence of a heartbeat is a mistake. Before 7 weeks, no diagnosis can be made. More or less informative transvaginal examination, starting from the 5th week from the moment of conception. It helps in the shape and size of the yolk sac to distinguish a frozen pregnancy from a normal one.

If a pathology is suspected in the early stages, a woman is prescribed a double examination: a transvaginal ultrasound and a blood test for the chorionic hormone. Only such a double analysis reveals the problem accurately and in a timely manner.

From the 13th week, a woman is prescribed dopplerography through the abdominal wall. It is based on the study of the blood flow of the mother and child, and the doctor determines the size of the fetus and uterus, whether they are normal, and also detects the fetal heartbeat.

To dispel any doubts, the patient is assigned a blood test for chorionic gonadotropin, a hormone released only during pregnancy. If it falls significantly below the norm, this indicates an undeveloped pregnancy.

In terms of 30 weeks, when a stop in the development of the fetus is fraught with the birth of a sick or dead baby, the patient comes to the aid of cardiotocography. It records the movement of the fetus and its heartbeat.

Only the ratio of the results of three types of research, ultrasound, dopplerography and cardiotocography, allows us to reliably state that the fetus has stopped in its development. The biggest mistake during an ultrasound is taking an ectopic pregnancy for a dead one.

Ultrasound for ectopic pregnancy: what allows you to see

An ectopic pregnancy is the development of an embryo not in the uterine cavity, but in an organ not intended for this. In most cases, the attachment of the fetal egg occurs inside one of the appendages. The danger is that at a later date, the ovum ruptures, pus enters the bloodstream, and sepsis begins.

The earlier the pathology is detected, the less the woman's health will suffer. The maximum period at which the elimination of an ectopic (ectopic pregnancy) is possible in a non-surgical way is 6 weeks. Therefore, you should consult a doctor at the slightest suspicion of an ectopic.

Not always ectopic pregnancy manifests itself in a special way. Sometimes a woman finds out about her in the gynecologist's office, where she goes because of pain in the lower abdomen, bleeding and fever. To dispel all doubts, the doctor refers the patient to an ultrasound. Transabdominal ultrasound will be ineffective, because it does not see pathology in the early stages. When diagnosing IMP, the doctor uses a transvaginal probe. It allows you to accurately examine the possible area of ​​​​attachment of the fetal egg - the fallopian tubes, the pelvic region, the posterior surface of the uterus.

With an ectopic pregnancy on the monitor, the doctor sees an oval neoplasm inside the appendage, inside which is the yolk sac. In order not to be mistaken and not to mistake the HMB for another neoplasm (hydrosalpinx), color mapping is additionally carried out - displaying on the monitor the zone of supply of the fetal egg with blood vessels. The uzist takes appropriate pictures and makes a conclusion.

In confirming the diagnosis, a specialist using ultrasound can analyze the indirect signs of HMP:

• the size of the uterus that does not correspond to pregnancy;
• accumulation of fluid in the pelvis;
• blood clots in the uterine cavity (false fetal egg);
• anomalies of the endometrium;
• enlarged cervix during cervical pregnancy;
• with abdominal IUD, the doctor sees an increased thickness of the placenta, practically does not see the wall of the uterus.

Before 12 weeks, the ovarian IMP cannot be determined, because the fetal egg looks like a follicle. However, an experienced doctor will see an anomaly.

Inexperienced doctors, using ultrasound devices of the old generation, confuse HMP with other diseases:

• with torsion of the fallopian tubes or ovary;
• yellow body cyst;
• cyst rupture;
• various neoplasms;
• hydrosalpinx.

The most optimal time for the detection of HMP is 4-6 weeks. In this case, the problem is eliminated by medication, and the woman does not undergo surgery. At a later date, laparoscopy or band surgery is done. This has more serious consequences: the formation of scars and adhesions on the appendages, inflammation, etc.

Ultrasound and diagnosis

Errors occur in the diagnosis:

• an inexperienced specialist confuses ovarian cancer with ascites (accumulation of fluid due to a cyst or damage to an organ);
• with ultrasound before the onset of menstruation, the doctor can see endometrial polyps, although it will be endometrium that has grown before the onset of menstruation;
• the transabdominal apparatus does not always see uterine myoma, especially along the back wall.

Even if the doctor sees obvious signs of pathology, he concludes with a diagnosis with a question mark and does not give any recommendations and conclusions during the study. It is necessary to talk about anything (surgery, removal, treatment) only with the attending physician, and only after repeated ultrasound and additional tests.

The specialist behind the ultrasound machine, unless he is the attending physician, does not have the right to express his views on the problem found.

Among the reasons why an uzist sees a problem where there is none, the following factors are often found:

• Physical and emotional fatigue. During the day, the specialist examines an average of 50 people, and by the evening the concentration of attention decreases.
• Old equipment, and the device may be relatively new, but its technical capabilities will not meet the needs.
• The inexperience of a specialist, the lack of professional flair and just human indifference.

Whatever the ultrasound machine shows, the results should always be double-checked. Even the most modern technology is not immune from mistakes.

Currently, at the first suspicion of pregnancy, immediately after a pharmacy test for the presence of hCG in the urine, women are in a hurry to undergo an ultrasound examination so that the doctor confirms the signs of a developing pregnancy.

Is it always possible to establish the presence of pregnancy, set the gestational age and detect abnormalities in the development of the fetus in the early stages?

To determine the presence and duration of pregnancy, the doctor. This access allows you to better examine the uterine cavity, more reliably measure the size and evaluate the structure of the fetal egg. In addition to visualizing the ovum itself, the doctor necessarily evaluates all the internal organs of the woman's reproductive system: the uterus, cervix, ovaries, and the bladder.
In thin women in the early weeks, the fetal egg is sometimes visible and.

Starting from the 11-12th week of pregnancy, the fetal structure, gestational age and signs of normal development are usually assessed using transabdominal ultrasound.

How can I determine the gestational age by echographic examination?

The gestational age is determined by the diameter of the fetal egg. To do this, the doctor measures the diameter of the fetal egg along its internal contour in 3 mutually perpendicular planes.

Then, using a special table, it calculates how many days and weeks the gestational age is.
Starting from the full 7 to 14 weeks of pregnancy, when the embryo already appears, the term is set. To do this, the image of the embryo or fetus is displayed longitudinally and the length is measured from its crown to the coccyx.

Normal values ​​of the coccygeal-parietal size (KTP) depending on the gestational age (full weeks + days), data in millimeters, the lower limit is the 5th percentile, the upper limit is the 95th percentile.

Then also in the table you can see the corresponding period. Often, the standards are stored immediately in the memory of the ultrasound machine, and then immediately after the measurement, it will show the gestational age on the screen.
In addition, when setting the gestational age, the doctor evaluates not only the size, but also the signs of normal maturation of the fetal egg or embryo.

At each specific stage of development, new organs and structures appear in its structure. Knowing these features, the doctor can see whether the development of the fetus corresponds to age norms.

On what day after the delay is it worth doing an ultrasound?

Transvaginal ultrasound will show a fetal egg in the uterine cavity when 4.5 - 5.0 weeks of pregnancy come. It is worth noting that doctors consider the duration of pregnancy from the first day of the last menstruation. That is, you should not immediately rush to an ultrasound scan if the delay in menstruation is 1 to 2 days. Sonography only after 3 - 5 days of delay from the date of the expected menstruation.

Why the ultrasound doctor may not see the embryo.

A quite common situation is when the pregnancy test is positive, and the woman goes for an ultrasound scan on the same day, but in the uterine cavity. Why can this be?

The egg is fertilized by sperm in the fallopian tubes, and the fertilized gradually moves along them to the uterus over several days. Approximately 4 weeks from the first day of the last menstruation, the embryo reaches the uterine cavity and implants in the endometrium.

In some women, ovulation and, accordingly, fertilization occurs later than the middle of the cycle, and therefore the embryo reaches the uterine cavity a little later. In this case, ultrasound may not yet show signs of a fetal egg in the uterus, although a pregnancy test will be positive. In this situation, the doctor prescribes a second ultrasound in 7-10 days.

It has been established that when the level of hCG in the blood is less than 1000-1200 IU / l, the fetal egg is not yet visible on ultrasound. It can be seen when hCG reaches 1500-2000 IU/L.

Another already dangerous situation, due to which the embryo may not be visible, is an ectopic pregnancy. A fertilized egg can be localized in the tubes, abdominal cavity. And if its size is small, the doctor will not be able to see it with ultrasound.

When you can already see the fertilized egg.

About a week after fertilization, the embryo enters the uterine cavity and begins to implant in its mucous membrane - the endometrium. At this time, the size of the fetal egg is still very small, and the resolution of the ultrasound scanner does not allow the doctor to see signs of the embryo. Two and a half weeks after conception, that is, the doctor is already beginning to see the fetal egg in the uterine cavity using transvaginal ultrasound.

The fetal egg looks like a rounded anechoic (black) formation with a bright whitish rim, 1 mm thick. The diameter of the formation itself is from 2 mm.
An average experienced doctor on an ultrasound scanner of the middle class can see a fetal egg for the first time starting from the gestational age of 4 weeks 3 days.

What indicators are used to measure in the early weeks.

In the early stages, as well as, measure the size of the uterus, ovaries, cervix.

Specific indicators that are necessarily determined in the first trimester are:

• diameter of the fetal egg (from 4 to 6 weeks);
• coccyx - parietal size (from 7 to 14 weeks);
• yolk sac diameter;
• the size of the corpus luteum in the ovary.

What are the anomalies of the fetal egg.

In the first weeks of gestation, for various reasons, deviations may occur, which in some cases lead to the threat or death of the fetus.

Among these pathologies, the following can be detected using ultrasound examination:

1. Attachment anomaly. Normally, for the favorable development of pregnancy, the embryo must be implanted in the bottom or middle third of the uterine cavity. If it is attached in the area of ​​the lower third or internal pharynx, then the risk of miscarriage is high.

2. Change in the shape of the fetal egg. Normally, it has a rounded shape. The elongated form is most often the result of increased uterine tone and also threatens miscarriage.

3. Infection of the ovum. It is manifested by the transformation of its shape into a round one and the appearance of a suspension in its cavity.

4. Non-developing pregnancy. It is manifested by the cessation of the growth of the embryo, the disappearance or deformation of the yolk sac in it after 6 weeks, the absence of an embryo after 7 weeks, the absence of a heartbeat in the embryo, and the lack of development dynamics during a control study after 7 days.

The reasons for the lack of development can be hormonal deficiency, genital tract infections, gross chromosomal abnormalities of the embryo, and others.

5. Anembryony. Manifested by the absence of embryoblast in the cavity of the egg after 6 weeks of pregnancy. At the same time, the fetal egg continues to increase in size and fill with fluid. This anomaly is a criterion for a non-developing pregnancy, but requires a follow-up study after a few days, since in rare cases a healthy embryo begins to be visualized later than the due date.

6. Trophoblastic disease. It is characterized by the development of a benign tumor inside the fetal egg. The cause of such an anomaly is most often inflammatory changes in the endometrium.

7. Polyhydramnios. This is an increased accumulation of amniotic fluid in the amniotic cavity. In the early stages, it can lead to placental abruption and death of the embryo.

Benefits of early screening.

Ultrasound is an essential diagnostic method when an obstetrician-gynecologist suspects that a woman has any pregnancy complications. Ultrasound helps, the threat of interruption, miscarriage, miscarriage.

In the early stages, with the help of ultrasound, the exact gestational age, the number of fetuses, their viability and the presence of gross developmental anomalies are determined.

Conclusion.

Ultrasound diagnostics helps doctors establish pregnancy just a few days after the delay in menstruation, as well as monitor the correct development of the embryo from the earliest possible dates. However, you should not visit the ultrasound room on your own weekly. This study in the first months of pregnancy should be carried out according to indications on the basis of any complaints in the pregnant woman or suspicion of violations in the development of pregnancy.

It is often difficult to study the work of the ovaries using a conventional ultrasound examination, because the ovary is simply not visible. But this in no way means that it is not in the body of a woman.

In what situations is the ovary not visible on ultrasound?

Difficulties in examining the ovaries in a patient during ultrasound diagnostics may arise:

• After surgery on the tubes of the uterus or the ovaries themselves;
• With a large size of the uterus;
• With deformation of the uterus from myomatous nodes;
• With severe pathology of the uterine tubes;
• With a severe polyetiological disease of the uterus, for the occurrence of which there may be many reasons: age-related changes in the female body, work in a hazardous enterprise, changes in the immune system, or neuropsychic stimuli.

Do not be upset if, during the examination, the specialists did not see the ovary on ultrasound. You just have to use a different method. For convenience and information content, ultrasound diagnostics of the ovaries often resort to transvaginal examination (endovaginal sound examination or transvaginal ultrasound). A transvaginal ultrasound is performed through the vagina.

Prerequisites for the transvaginal research method

Your gynecologist may refer you for a transvaginal ultrasound if:

• Pain in the pelvic area;
• Infertility;
• Bleeding or irregular menstruation;
• Suspicion of an ectopic pregnancy;
• Neoplasms on the female internal genital organs, identified during a physical examination of the patient.

How to prepare for a transvaginal ultrasound?

No special preparation is required. The only condition is an empty bladder. Already in the office, the doctor will ask you to completely undress below the waist, take a horizontal position on the couch and relax the muscles of the lower body. The procedure is absolutely painless. You may feel some discomfort from the pressure of the sensor on the walls of the vagina.

How is an endovaginal sound examination performed?

For maximum diagnostic information, it is very important to correctly position the sensitive sensor. It is most convenient to examine the ovaries when the woman lies on the couch with her legs bent at the knees. To exclude trauma and infection of the vagina, a condom is put on the sensor. The condom is lubricated with a special gel before insertion, which minimizes friction.

Health hazards in transvaginal ultrasound diagnostics

Unlike x-rays, ultrasound examination is absolutely safe for a woman's health. This method has only positive characteristics. Today, in every medical center, diagnosticians resort to the help of ultrasound equipment. The speed and accuracy of the procedure help to diagnose unwanted deviations of women's health from the norm in time. The painlessness of the procedure helps to eliminate unnecessary excitement of the patient.

cimax-kino.ru

Yellow body on ultrasound after ovulation: what does it mean

The corpus luteum on ultrasound after ovulation is a natural process in the female body, which means the release of a mature egg and a high chance of conception. By the time of the onset of menstruation, the temporary gland self-destructs, the effect on the body of progesterone, which causes acne in many women, increases, breast tenderness during PMS decreases, and a new cycle begins.

The second name of the corpus luteum (VT) is the luteal gland.

What methods will help to find out about the presence of a corpus luteum

There are two ways to find out about the existence of a temporary gland:

1. Ultrasonography. The most reliable method that allows you to clearly see the picture of what is happening on the monitor, determine the size, the likelihood of conception, the effect of VT on the reproductive organs.
2. Analysis for the hormone progesterone. Relying on this method alone is not enough, because there are situations with hormonal failure.

If a woman is tracking ovulation in order to get pregnant, then the most common solution is to use both methods at the same time.

Corpus luteum after ovulation on ultrasound

On ultrasound, the gland looks like a round, soft sac located on one of the ovaries or on 2 at once. In the latter case, multiple pregnancy is likely with successful fertilization of the egg.

After ovulation has taken place, the gland appears almost immediately, gradually increasing in size. To assess the state of reproductive function, especially the ovaries, it is recommended to do an ultrasound three times per cycle:

• on day 7-10 of the cycle. At this time, the mucous membrane of the uterus is quite thin and allows you to see hidden pathologies, and the ovaries after the last menstruation are “refreshed”;
• on the 14-16th day of the cycle. The follicle is just starting to grow, so the study is prescribed to find out if there is ovulation, pathology, neoplasm development or not;
• on day 22-24 of the cycle. The preparation of the body for menstruation begins, so experts look at the changes in the ultrasound picture after ovulation: what happens to the follicle, has it turned into a cyst, has it disappeared, etc.

A three-time study will accurately show the picture of the functioning of the genital organs, and also indicate the specific day of ovulation, because the individuality of each organism knows no boundaries: the follicle can begin to develop much earlier than the 14th day of the cycle, and later than the 24th.

Table of sizes of the corpus luteum after ovulation based on the conclusion of the ultrasound:

If the size of the luteal gland at the end of the monthly cycle is from 12 to 15 mm, then this indicates the reverse development of VT. The value of 24-30 mm indicates the possible presence of a normal pregnancy. From 30 mm or more - the appearance of a VT cyst, in which case therapy is prescribed and pregnancy planning is postponed. But if it has already come, they are carefully monitored during the first trimester. There is no serious threat.

The constant presence of the luteal gland also speaks of cystic formation. The normal duration of the "life" of VT is 13-14 days, until the onset of menstruation.

What does the absence of the luteal gland mean?

If there is no corpus luteum in the ultrasound picture, the probable causes include:

1. Anovulatory cycle or late ovulation. If the gland is not visible, then ovulation will either not happen at all, or it will happen later.
2. Follicular cyst. The follicle did not mature, did not grow to its size, stopped developing, did not break, turning into a formation that often disappears on its own in the next cycle with a temporary failure (if follicular cysts appear systematically or are poorly absorbed, the reason lies in the woman's reproductive health).
3. Infertility and other diseases of the small pelvis. Follicles may not develop at all. In this case, a thorough examination, search for the root cause, and its elimination are necessary.

Every woman has anovulatory cycles during which the corpus luteum is absent - this is a normal and natural process. However, the occurrence of anovulatory cycles systematically is a serious reason to be examined.

oyaichnikah.ru

Ultrasound of the ovaries reveals cysts, infertility and cancer | Clinic Diana in St. Petersburg

Ultrasound is widely used to diagnose a huge number of pathologies in the human body. It is also indispensable when examining the reproductive system of a woman. Ultrasound of the ovaries is an affordable and absolutely harmless method for studying the shape, size, location and structure of the organ, as well as the follicular apparatus.

Indications for ovarian ultrasound

As an independent procedure, it is carried out quite rarely. As a rule, ultrasound of the ovaries is done in combination with an ultrasound examination of the pelvic organs. In some cases, the procedure is prescribed if it is necessary to assess the functional activity of the ovaries. This is mainly necessary when diagnosing the causes of female infertility.

In this case, an ovarian examination is done to measure the dominant follicle when a woman is unable to conceive for a long period. In this case, for a certain period, the doctor monitors the follicle and records the fact of the onset or absence of ovulation. This examination of the ovaries is called folliculometry.

Also indications for the appointment of ultrasound of the ovaries are:

• irregular menstrual cycle, lack of menstruation (unless it is during pregnancy);
• regular pulling or sharp pain in the lower abdomen;
• pain during intercourse;
• too little or heavy menstrual bleeding;
• unusually severe menstrual pain;
• disease of the mammary glands;
• suspicion of infertility;
• inflammation of the appendages;
• suspicion of pathology;
• preparation for pregnancy;
• preparation for IVF;
• preventive examination.

What pathologies are detected by ultrasound examination of the ovaries

Ultrasound of the ovaries is a fairly effective method in detecting pathologies, and with its help it is possible to detect some diseases even at the preclinical (before the onset of symptoms) stage, and those pathologies that cannot be detected using other research methods.

• An ovarian cyst (functional and pathological) is a benign neoplasm characterized by the formation of a fluid-filled protrusion on the ovary (or both at once). Pathology is dangerous by degeneration into a malignant tumor, provocation of infertility, peritonitis, or disruption of neighboring organs.
• Polycystic ovaries is a hormonal disease in which the ovaries increase in size and accumulate a lot of cysts. The disease provokes infertility, because it does not allow ovulation to occur, i.e. the release of eggs from the ovary.
• Salpingoophoritis is a joint infectious and inflammatory process in the ovaries and fallopian tubes. Independent inflammation of the ovary - oophoritis - is quite rare. The pathological process is caused by infection (streptococci, staphylococci, chlamydia, etc.). Most often it comes from the vagina and uterus along the ascending path.
• Torsion of the ovary is a serious pathological condition in which the nutrition of the ovary is disturbed. Requires immediate medical attention.
• Malignant tumors - cancer.

Sonography technique

There are three ways to examine the ovaries using ultrasound. The doctor makes the choice of a specific method taking into account the patient's history.

• Transabdominal - carried out using an external sensor through the abdominal wall. This method is the most comfortable, but the least informative, it can only detect a gross violation of the organ. It is usually used during a general gynecological examination, for virgins and women with malformations of the vagina.
• Transvaginal - is carried out using an intracavitary sensor (transducer), which is inserted into the vagina. The method is the most accurate and informative, since the sensor is in close proximity to the internal organs. May be accompanied by slight discomfort during the insertion of the probe. This type of ultrasound is contraindicated for virgins and with malformations of the vagina.
• Transrectal - carried out using an intracavitary probe (thinner than for TVU), which is inserted into the rectum. The method is absolutely painless, but very uncomfortable for a woman. It is carried out in some cases when TAU turned out to be insufficiently informative, and TVU cannot be performed for objective reasons (virginity, atresia (fusion), severe stenosis (narrowing) of the vaginal entrance, etc.).

The duration of the procedure is about 15 - 20 minutes.

How to prepare for the procedure

Each research method requires special training in order to obtain the most accurate and informative result.

Transabdominal ultrasound of the ovaries

This type of study requires careful preparation, including a slag-free diet and cleansing the intestines from gases. 2-3 days before the procedure, it is necessary to stop eating foods that cause flatulence (carbonated drinks, beans, fresh fruits and vegetables, yeast and dairy products, etc.). For a day, start taking absorbent drugs (smecta, espumizan, activated charcoal, etc.).

During the procedure, the bladder must be full, so a woman needs to drink 1 liter of liquid (non-carbonated and non-dairy) an hour before her and not urinate.

Transvaginal ultrasound of the ovary

Special preparation for such an ultrasound is not needed, since the only condition for its implementation is an empty bladder. Immediately before the procedure, a woman just needs to urinate. If there is a tendency to increased gas formation, in a day - two should start taking drugs that reduce flatulence (smecta, espumizan, activated charcoal, etc.).

Transrectal ultrasound

Preparation for such an ultrasound is similar to preparing for a transvaginal examination. Additionally, for 9-10 hours, it is necessary to cleanse the intestines from feces with a cleansing enema (1-1.5 l), microclysters, glycerin suppositories or laxatives.

The timing of the study depends on its purpose. If the ultrasound is planned, then it is carried out on the 5th - 6th day of the menstrual cycle and no later than a week after the end of menstruation. In severe situations, an ultrasound scan is performed on the day symptoms are detected. If it is required to evaluate the functioning of the ovaries, then the procedure is prescribed three times (on the 8-9th day, on the 14-15th day and on the 22nd-23rd day of the menstrual cycle).

How is the procedure carried out

transabdominal method. The patient lies back on the couch and exposes the abdomen. The doctor applies a special gel to the area of ​​the abdomen projected to the ovaries to improve contact with the sensor, and then scans the ovaries by moving the device over this area.

transvaginal method. The patient exposes a part of the body below the waist and lies on her back on the couch, bending her knees. The doctor gently inserts a cavity sensor into the vagina, on which he previously put on a condom to prevent the ingress of foreign microflora and lubricated it with a lubricant. The transducer is inserted shallowly, about 5-8 cm.

transrectal method. The patient exposes the lower part of the body and lies sideways on the couch, bending her knees. The doctor slowly and carefully inserts a sensor into the anus, on which a condom was previously put on and a lubricant was applied in order to minimize discomfort and discomfort for the woman.

During the examination, the doctor evaluates the structure of the ovaries, their condition, size, localization, confirms or refutes the presence of pathological changes and inclusions. Upon completion of the procedure, he gives the patient an ultrasound report, with which the woman should contact the treating specialist for treatment.

Deciphering ultrasound of the ovaries: norms

Normally, the ovaries are located on the sides of the uterus at a small distance from it, often asymmetrically. On the monitor, they are visualized as oval, rather outlined, hypoechoic formations, while the ovaries are not identical to each other, the difference in their sizes is minimal. Their normal surface is considered bumpy due to the follicles ripening in them. The more time has passed since the beginning of the cycle, the larger these tubercles.

Normally, cystic, tumor-like and other formations should be absent in the ovaries, and the organ itself should not be enlarged. The interpretation of the results contains an indication of the size of the ovaries and follicles.

Normative indicators of the size of the ovaries are presented in the table. Values ​​may vary depending on the age of the patient, the phase of the cycle, the number of pregnancies, etc.

After the onset of menopause, the ovaries in size and volume decrease by almost 2 times (up to 2 cm3 on average), their silhouette becomes uneven, wrinkled, and echogenicity increases.

Normally, the ovaries consist of a capsule and follicles of varying degrees of maturity, the number of which may differ on the left and right. In healthy women, the following indicators of follicles are visualized depending on the phase of the menstrual cycle:

Why the ovaries are not visible on ultrasound

In some cases, the doctor cannot recognize the ovary on ultrasound. This can happen for the following reasons:

• congenital absence of ovaries;
• removal during surgery;
• premature exhaustion of the organ;
• sharp swelling of the intestine;
• high density of the abdominal wall with pelvioperitonitis;
• severe adhesive disease of the small pelvis;
• dense fat layer or scars on the anterior abdominal wall.

In this case, a second study is usually carried out, in preparation for which an obligatory emphasis is placed on getting rid of flatulence with the help of medications.

Pathologies of the ovaries and their signs on ultrasound

Some diseases, such as luteal (yellow body cyst) and follicular cyst, are considered "normal" and do not need treatment, since they usually heal spontaneously as soon as the hormonal background changes. Other cysts and diseases are pathological and require mandatory treatment.

On ultrasound, the cyst looks like a formation of 2.5 cm with fluid inside, which has a different structure and degree of staining.

Any pathology detected on ultrasound of the ovaries must be confirmed by other research methods, only after that an accurate final diagnosis can be made.

Research Alternative

There are many alternative methods for examining the ovaries, among which the most commonly prescribed are:

• computer and magnetic resonance imaging;
• puncture of the Douglas space with subsequent cytological analysis of the washout;
• diagnostic laparoscopy (laparotomy) with express biopsy and smear-printing.

Ultrasound of the ovaries is the most versatile method of examination and stands out among the rest.

Its advantages are the following:

• non-invasive (without tissue injury) research method;
• painless;
• much cheaper and more accessible than other methods;
• absolutely harmless to the body - ionizing radiation is not used, therefore it can be carried out repeatedly;
• excellent visualization of soft tissues, unlike X-ray;
• ideal for monitoring intrauterine development of the fetus;
• shows the state of the body in "real time", thanks to which even an acute disease can be diagnosed without resorting to puncture of the posterior vaginal fornix and biopsy.

Where to do an ultrasound of the ovaries in St. Petersburg, the price of the examination

You can sign up for an expert pelvic ultrasound, which includes a complete examination of the ovaries at the DIANA clinic (St. Petersburg), on our website. The cost of a comprehensive examination will be only 1000 rubles. In this case, the study will be carried out using a new device with Doppler (manufacturer SAMSUNG MEDISON). Here you can take any tests. We work without days off and lunch!

medcentr-diana-spb.ru

2018 Women's Health Blog.

When a long-awaited pregnancy occurs, a fertilized egg descends into the uterine cavity and attaches to its wall. Thus, the development of an embryo surrounded by a fetal egg occurs. The first month, from the date of fertilization, the embryo is so small that it is very difficult to visualize it. That is why the first ultrasound is done at 6-7 weeks so that you can examine the embryo and confirm the onset of pregnancy.

Why is the embryo not visible on ultrasound?

It happens that a woman who saw the long-awaited two stripes on the test comes to the doctor and hears: "The fetal egg is empty, the embryo is not visible on the ultrasound." This phenomenon is called an embryonic pregnancy.

If a pregnant woman is given anembryony, this means that with an increase in the level of hCG in the blood, there is no embryo in the fetal egg. It is difficult to say exactly which week specialists will be able to see the embryo on an ultrasound scan. This period ranges from 5 to 9 weeks, depending on certain factors:

1. Features of the body of each particular woman.
2. The correctness of the calculation of the period from the date of conception.
3. What kind of pregnancy is on the account. With each subsequent pregnancy, the probability of detecting an embryo earlier increases significantly.

On average, it is determined that visualization of the embryo is feasible at 7 weeks from the date of conception, with an active ongoing increase in the level of hCG in the blood. However, even if at this time the experts did not see the embryo in the fetal egg, you need to panic only if the growth of the hCG level has stopped or it has begun to decline. This picture indicates that the pregnancy is frozen. However, it won’t hurt to make sure of this once again, so it’s worth double-checking everything with another doctor or doing an ultrasound transvaginally.

A woman needs to see a doctor if, a few weeks after the growth of the hCG level has stopped, the embryo is not visible in the fetal egg, even when examined transvaginally, while the gestational age is approaching nine weeks. Stopping the growth of the embryo and the beginning of its decomposition may be accompanied by such concomitant symptoms:

1. An unreasonable jump in body temperature.
2. Appearance of nausea and vomiting.
3. Constant weakness, muscle pain.
4. Lower abdominal pain.
5. The appearance of discharge with blood impurities or open bleeding.

Do not delay a visit to the doctor and postpone the curettage procedure. The decomposition of the embryo can threaten a woman with serious health problems.

At what time should the embryo be visible on ultrasound?

While waiting for the birth of a baby, a woman wonders at what time the embryo can be examined on an ultrasound scan? During the diagnosis for a period of 5-6 weeks, the fetal egg is about seven millimeters in diameter. At this time, in most cases, the doctor already visualizes the embryo. Around this time, you also manage to hear how his heart beats.

If you have a regular menstrual cycle, an embryo should be visible at the end of the sixth week. If the ultrasound does not show the embryo, it is recommended to undergo a second examination in a week to exclude all possible deviations.

There are also cases when the fertilized egg is outside the uterus. During ultrasound, the egg is not visible well enough, or it is not visible at all. In this case, the heartbeat is heard outside the walls of the uterus.

What to do if the fetus is not visible on the ultrasound and what can this mean?

There are situations that during the ultrasound scan, the embryo is not visualized inside the fetal egg, and sometimes the fetal egg itself. First of all, try not to panic. Maybe there is no pregnancy at all, or there was an error with the calculation of its term, so it is still difficult to diagnose. If the frozen pregnancy is not exactly confirmed, there is no need to rush to clean. First, it is better to undergo an ultrasound scan again, in another clinic. It may be necessary to conduct one or more studies. The best option is when, in parallel with the diagnosis, the level of hCG in the blood is monitored. If the pregnancy develops without deviations, then its level increases. This helps specialists to exclude a possible frozen pregnancy.

If an ultrasound does not show an embryo in a fetal egg, what does this mean?

Very often, a fetal egg without an embryo is diagnosed in the uterine cavity in young and healthy girls. Why is the fetus not visible on ultrasound, and is it possible to avoid a missed pregnancy?

There are many reasons for this phenomenon. This can be caused by infections of various etiologies, exposure to toxic substances, etc. on the body. You can minimize the possibility that an embryo will not be visible on an ultrasound by planning your pregnancy in advance in order to accurately calculate the gestational age. Also, you need to undergo examinations and, before planning the conception of a baby, cure all existing infections. This is especially important for women who are planning a pregnancy over the age of 35. This category has a significantly higher risk of chromosomal abnormalities in the fetus.

The absence of an embryo in a fetal egg often does not give a woman any signs during pregnancy. There may be bleeding if a miscarriage has begun. Even a gynecologist during the examination will not be able to say for sure whether there is an embryo in the fetal egg, or whether it is empty. The diagnosis of anembryony can only be made by a doctor who performed an ultrasound examination for a period not earlier than 5-6 weeks. If the gestational age is considered from the first day of the beginning of the last menstruation, then the doctor can visualize the embryo on ultrasound at 1-2 weeks of delay.

It is extremely rare for a patient to be misdiagnosed after an ultrasound, therefore, if there is no embryo in the fetal egg, it is necessary to check the result in a week on other equipment if there are doubts about the professionalism of the doctor or the quality of the ultrasound machine. An error is also possible for other reasons: a short gestational age or late ovulation, a woman's overweight and.

Why can't you see an embryo on an ultrasound?

If the pregnancy test shows two stripes, and the embryo is not visualized on the ultrasound, the reason for this may be:

1. Incorrect calculation of the gestational age from the moment of conception. The embryo may not be visible because the woman is doing the test too early.
2. Ultrasound diagnostics was carried out on an old apparatus or the specialist did not have the proper level of qualification.
3. The study was done through the abdomen, not transvaginally.
4. The pregnant woman had a miscarriage, but she did not pay attention to it (confusing it with the onset of menstruation), while the level of hCG in the blood had not yet decreased to its previous value.

If the ultrasound does not show the embryo in the fetal egg, do not immediately panic. For a number of reasons, the diagnosis of anembryonia can be erroneously made, so it is necessary to control the level of hCG in the blood and undergo the diagnosis again.