A Step In The Right Direction

So our 6-week ultrasound was yesterday and it went well. The technician that performed it, Elizabeth, has done many of my tests in the past year. She said she wondered what happened to me after the last ectopic she found. She started out with an abdominal scan to measure my ovaries, then she proceeded on with the transvaginal ultrasound. She was asking questions about whether I had been experiencing any pain or bleeding with this pregnancy. Those questions made me very nervous. Just show me the baby already!

After scanning around for a couple of minutes looking at stuff that I didn't recognize, she finally got to the uterus. She pointed out a gestational sac that contained a yolk sac INSIDE MY UTERUS! So my worst fears of having another ectopic pregnancy were finally gone. Thank you Lord! Then there was the question of how far along I really am. According to my LMP, I should be 6 weeks yesterday. However, at 6 weeks you should be able to see a fetal heartbeat. So Elizabeth determined that I must be only 5 weeks, which is fine with me so long as everything looks the way it should.

We left there with some pretty good assurance that we have a normal pregnancy this time. Third time's a charm! I am still so cautious though because I want to see a baby or a heartbeat before I am convinced that everything is okay. I don't want to get my hopes up again only for my hopes to be shattered with loss. I am trying to have faith though that whatever the outcome of this pregnancy...it is God's will. That is so hard for me to do sometimes since I am human and all.

I have an appointment with my OB scheduled for August 2nd. She will do her normal first prenatal exam which will include an ultrasound. We should be able to see and hear a heartbeat at this visit. So for the next 3 weeks and 3 days I have to stay positive and have peace about what is to come. I'm praying for no complications from here on out. My mom reminded me this morning, "God is the giver of life." Those are words I need to tell myself daily. :)

I pasted some information below about where I am at this stage of my pregnancy. I told my mom that we have access to too much information sometimes where pregnancy is concerned. When she was having babies, they didn't have ultrasounds to check this or that or even determine the sex of the babies. A woman knew she was pregnant when she missed her period. She knew there was really a baby in there when she felt the baby move. I am thankful for the technology we have these days, but maybe it just gives us too much to worry about.          

Gestational Sac
The gestational sac is the earliest sonographic finding in pregnancy. The gestational sac appears as an echogenic (bright echoes) ring surrounding a sonolucent (clear) center. The gestational sac does not correspond to specific anatomic structures, but is an ultrasonic finding characteristic of early pregnancy. Ectopic pregnancies can also have a gestational sac identified with ultrasound, even though the pregnancy is not within the endometrial cavity. 

The gestational sac first appears at about 4 weeks gestational age, and grows at a rate of about 1 mm a day through the 9th week of pregnancy. 

Your ability to identify an early gestational sac will depend on many factors, including the capabilities of the ultrasound equipment, your approach (vaginal or abdominal), your experience, the orientation of the uterus (generally it is easier to see if the uterus is anteflexed or retroflexed), and the presence of such complicating factors as fibroid tumors of the uterus. While a gestational sac is sometimes seen as early as during the 4th week of gestation, it may not be seen until the end of the 5th week, when the serum HCG levels have risen to 1000-1500 mIU.

Gestational sac size may be determined by measuring the largest diameter, or the mean of three diameters. These differences rarely effect gestational age dating by more than a day or two.

1st Trimester Ultrasound Scan

Yolk Sac
As the pregnancy advances, the next structure to become visible to ultrasound is the yolk sac. This is a round, sonolucent structure with a bright rim. 

The yolk sac first appears during the fifth week of pregnancy and grows to be no larger than 6 mm. Yolk sacs larger than 6 mm are usually indicative of an abnormal pregnancy. Failure to identify (with transvaginal ultrasound) a yolk sac when the gestational sac has grown to 12 mm is also usually indicative of a failed pregnancy.

Yolk sacs that are moving within the gestational sac ("floating"), contain echogenic material (rather than sonolucent), or are gross misshapen are ominous findings for the pregnancy.