122 Beats per Minute!

So I went in for my second ultrasound today. It went wonderfully! There was a heartbeat and it was 122 BPM which is right where it should be right now.  The baby is measuring at about 6 weeks 5 days and by my estimates I’m 6 weeks 6 days so it looks like we’re right on track. Here’s the boring report too:

 

TRANSABDOMINAL/ENDOVAGINAL FIRST TRIMESTER OBSTETRICAL ULTRASOUND

CLINICAL HISTORY: 26-year-old pregnant woman (gravida 2, ectopic
1) with regular, 28 day cycles and confident menstrual dating
(last menstrual period: 1 June 2010, 8.9 weeks ago) whose study
is performed to re evaluate for embryo and cardiac activity.
Prior comparison IHC Urban Central Region imaging: 21 July 2010,
at 7.1 menstrual weeks. Reportedly the patient has 41 day cycles
and believes she ovulated "late" (by her own calculation of
ovulatory dating she expects 6.9 week size today. By prior
imaging expect 7.9 week size today.

PROCEDURE: High resolution real time curved array 4.0 megahertz
contact harmonic imaging of the pelvis is performed through a
distended bladder in longitudinal and axial planes. After
obtaining informed consent and in a standard fashion
supplementary endovaginal curved array 7.0 megahertz imaging was
also performed. Our study included permanent storage of recorded
images. We obtained the following pertinent measurements:

Crown Rump Length: 8 mm, 6.7 weeks
Average Chorionic Sac Diameter: 2.7 cm, 8.3 weeks

FINDINGS: Midline anteverted uterus measuring 10.1 cm
longitudinal x 3.9 cm anteroposterior x 5.2 cm transverse.
Myometrium is homogeneous and normal in sonographic appearance
and symmetrically surrounds a solitary fundal intrauterine
chorionic sac with sharply defined smooth margins. Within
chorionic sac I define a solitary normal appearing yolk sac and
today an adjacent live embryonic pole. Cardiac activity is today
apparent and is documented and shown to the patient during our
study (122 beats/minute). No chorioamniotic separation or extra
chorionic blood. The surrounding decidual reaction is homogeneous
and normal in sonographic appearance. Sonographic size 6.7 weeks
(range: 6.1-7.3 weeks), expected size 7.9 weeks, ovulatory dating
6.9 weeks; all reflecting good agreement and consistent with
appropriate interval growth. Charting is based on menstrual
dating in view of this good agreement. At this early point in
pregnancy I am unable to accurately predict placental
distribution, exclude previa or assess cervix. Amniotic fluid
volume within the chorionic sac is normal.

No free pelvic fluid. Normal posterior cul-de-sac. Adnexal
dimensions on the right are 3.6 x 3.1 x 2.0 cm; the left measures
2.9 x 3.0 x 1.4 cm. Ultrasound is not and cannot be tissue
specific but the sonographic appearance of each ovary is normal;
characterized by small peripheral sonolucencies, usually
follicular cysts. Color flow Doppler evaluation confirms blood
flow at each ovary; torsion or ischemia are less likely. The
right adnexal 16 mm apparent corpus luteum cyst of pregnancy now
measure less than 1 cm in average dimension.

IMPRESSION:

1. I document a solitary fundal intrauterine chorionic sac now
with a solitary well documented live embryo. Sonographic
morphology is normal for early gestation, by standard criteria.
My identification of intra uterine chorionic sac makes coexistent
ectopic gestation unlikely.
2. Sonographic size 6.7 weeks, expected size 7.9 weeks,
ovulatory dating 6.9 weeks; all reflecting good agreement and
consistent with appropriate interval growth since imaging in mid
to late July.
3. Expected date of delivery by ovulatory dating: 21 March 2010.

4. Please see above for additional details and discussion of
today's maternal embryonic evaluation.