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Pregnancy - Gestational age and uterine bleeding

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I went to the doctor the other day believing I was 5 weeks pregnant based on what I thought was my period. I told the dr I had exposures such as X-rays of my knees, 7 nights of alcohol-usually 1 drink but two nights could've been 4 drinks at most( I had a margarita and domes there are 2-4 shots in those drinks), I took one hydrocodone on two different night and I sat in a jacuzzi for 45 minutes, and I was training for a half marathon. My dr said there were no red flags..,also, she said it was to my advantage that I was so early. She performed an ultrasound that day to confirm gestational age; she said it may be two weeks before she sees heartbeat and embryo.


Well, guess what? Ultrasound shows everything: embryo, yolk sac and heartbeat of 111. Now, I am uncomfortable, but dr said she is not concerned at all. I have been pregnant four times in the past and all ultrasounds were on target. I am concerned that the bleeding I had was not a period, but uterine bleeding. It occurred after intercourse, was bright red with some clots and only lasted 3 days and there was also brown blood.


I am concerned this baby is three weeks behind, not one week ahead. Shouldn't this dr have some questions about iltrasound since I had exposures? My cycles are consistently 28 day. Finally, when I told her my last period was normal, she said she didn't care; she is using the ultrasound date.

Category: OBGYN

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Category: Infertility Specialist
 22 Doctors Online



Thank you for asking your query at

From your description I understand that you assumed that your pregnancy to be 5 weeks old, but now concerned it is more than 5 weeks, because you are not sure about the last menstrual period, whether it was menstrual bleeding at all.


Now even in that case, I should say the gestational age is corresponding to the ultrasound. Heart beats are usually visible only by 7-8 weeks of pregnancy. A discrepancy of one or two weeks may be considered within normal limits. So your ultrasound is more or less on ‘target’ and there is no need for any concern regarding that as of now.


I understand that you have been exposed to alchol, xray, physical strain, drugs etc during early pregnancy. While these are considered risky and bad for the growing fetus it’s not necessary that it should do some damage always. Most of the time the baby will be safe and you just need to take precautions here after. Incase you do not want to continue with the pregnancy I recommend you to go ahead and discuss it with your Doctor (Ofcourse as per your religious / ethical and legal views). You should decide, after discussion with your partner whether you should go ahead with the pregnancy and then take an informed decision.

Patient replied :

Is it likely or unlikely the baby suffered symmetrical iugr?  The crown rump length measured 6 weeks 3 days and heartbeat is 111. Based on my last normal period, the ultrasound would be measuring 2 and 1/2 weeks behind the gestational age.



To help you with your queries, can you provide me with the following information :


1.Last date of bleeding per Vagina , and how it was different from your normal menstrual bleed.

2.LMP (Last menstrual period) -

3.Date of the USG -

4.Your normal menstrual cycle duration and length -


Thank you.

Patient replied :

1. Start of last vaginal bleeding was Jan 6. Brown spotting on the 7 then it stopped.  On the 8 brown blood with tissue-like material then bright red blood with clots for two days and then brown spotting. It was different because  the flow was not as heavy and it did not last as long.


2.  Dec. 9 was date of last normal period.


3.  Ultrasound was Feb 13.


4.  Normal cycle is 5-6 days with heavy flow. 



Thank your reply. 


If you consider Jan 6 as the LMP, then the gestational age by menstrual period is corresponding to the the Crown rump length. If Dec9 is considered then there is 3 weeks lag. Now I want you to understand that CRL (Crown rump length) comes useful typically in these kind of situations. When there is doubt regarding the LMP, you go for CRL measurement. CRL measurement gives you the accurate gestational age of the fetus.


Now coming to IUGR. This found out by measuring certain other parameters via USG (and some times blood sampling) and then comparing it with a normal fetus of corresponding CRL. If you are concerned about IUGR, I would recommend you to visit a specialist in prenatal USG/Doppler and seek further advice. As of now there is nothing to suggest the baby has IUGR. As I said earlier, it is premature to comment on IUGR and growth. 


Hope this helps.

All the best wishes.

Patient replied :

Since CRL and heart rate of 111 both correspond to gestational age of six weeks, is it more likely GA is six weeks? Also, I went to dr yesterday for ultrasound and baby's growth rate was normal and heart rate was 156.  Dr said she isn't worried.  If there was iugr in the beginning to cause a three week lag, would the growth rate typically continue to lag?



Yes, the Gestational age by CRL is more accurate, that is 6 weeks. There is nothing to suggest a IUGR of 3 weeks as you say so there is not question of lag i guess.


Hope this helps.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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