What does intrauterine pregnancy mean? Is intrauterine pregnancy normal?
Intrauterine pregnancy is caused due to poor growth of a fetus while in the mother’s womb at the time of pregnancy. Most often, causes of intrauterine pregnancy may include poor maternal nutrition or lack of adequate oxygen supply to the fetus.
Out of four million infant deaths around the world, at least 60% are associated with low birth weight (LBW) caused due to intrauterine growth restrictions, genetic abnormalities, and preterm delivery showing that undernutrition is already a leading health problem at the time of birth.
The best gynecologist in Chennai claims that patients who have echogenic material identified within the endometrial cavity at transvaginal ultrasonography are unlikely to have normal intrauterine pregnancy.
The pregnancy is usually diagnosed by a positive urinary pregnancy test after one missed a period. The earliest the pregnancy could be diagnosed by serum beta-hCG is nine days after ovulation or the 23rd day of gestation, yet it cannot confirm an intrauterine pregnancy or its viability which will hence require an ultrasound examination.
The role of serum beta-hCG
In the case of intrauterine pregnancy, the serum beta-hCG doubles in less than 48 hours, while in ectopic pregnancy it takes more than 48 hours. At least 15% of normal pregnancies may have an abnormal hCG rise, and in case of miscarriage of an intrauterine pregnancy, the serum beta-hCG levels may be inconclusive.
The role of ultrasound
The transvaginal scan is more sensitive than a transabdominal scan and can detect an intrauterine gestational sac at 4-5 weeks, an embryo at five weeks and fetal heartbeat at 5-6 weeks of gestation at the earliest.
The absence of an intrauterine gestational sac with such high levels of serum beta-hCG means that there is an ectopic pregnancy or recent complete miscarriage. An empty uterus with a positive urinary pregnancy test may also be due to very early pregnancy and needs a repeat ultrasound scan.
Importance of early confirmation
The confirmation of an intrauterine pregnancy at an early stage is necessary as it would avoid any confusion, unnecessary investigations, and interventions in early pregnancy problems. With the arrival of expectant and medical treatment and conservative laparoscopic management of ectopic pregnancy, an early diagnosis has become more important.
It reduces the patient’s anxiety associated with uncertainty about the diagnosis, investigations, and interventions. It also helps save resources and the cost in the long run.
The primary vascular-change
During early embryological development, trophoblastic lacunae develop from the spiral arteries on day nine or the 23rd day of gestation as vacuoles open within the syncytiotrophoblasts. The uteroplacental circulation is established by the 21st day or five weeks of gestation, and the heart begins to beat on 22nd day or five weeks and 1-day gestation.
Crown-rump length
Growth is approximately 1.2 mm per day, which may also be delayed in a normally developing pregnancy. Interval growth of Crown-rump length alone should not be used as a determinant of pregnancy loss.
Cardiac activity
The embryonic cardiac activity should always be visualized with a crown-rump length of more than or equal to 7mm. A slow embryonic heart rate of less than 80 bpm may suggest a guarded prognosis for the pregnancy. One must suggest a follow-up scan if clinically appropriate.
The earliest site of a pregnancy can be confirmed by the modalities available in clinical practice is 4-5 weeks. After considering the wide variability in actual efficiency in practice, the diagnosis is often delayed causing a lot of concern for the women and the gynecologists involved in her management.
This also increases the cost of treatment through the prolonged hospital stay, repeated hospital attendances and investigations, and sometimes unnecessary interventions.
Out of four million infant deaths around the world, at least 60% are associated with low birth weight (LBW) caused due to intrauterine growth restrictions, genetic abnormalities, and preterm delivery showing that undernutrition is already a leading health problem at the time of birth.
The best gynecologist in Chennai claims that patients who have echogenic material identified within the endometrial cavity at transvaginal ultrasonography are unlikely to have normal intrauterine pregnancy.
Meaning, causes, and diagnosis of intrauterine pregnancy
The pregnancy is usually diagnosed by a positive urinary pregnancy test after one missed a period. The earliest the pregnancy could be diagnosed by serum beta-hCG is nine days after ovulation or the 23rd day of gestation, yet it cannot confirm an intrauterine pregnancy or its viability which will hence require an ultrasound examination.
The role of serum beta-hCG
In the case of intrauterine pregnancy, the serum beta-hCG doubles in less than 48 hours, while in ectopic pregnancy it takes more than 48 hours. At least 15% of normal pregnancies may have an abnormal hCG rise, and in case of miscarriage of an intrauterine pregnancy, the serum beta-hCG levels may be inconclusive.
The role of ultrasound
The transvaginal scan is more sensitive than a transabdominal scan and can detect an intrauterine gestational sac at 4-5 weeks, an embryo at five weeks and fetal heartbeat at 5-6 weeks of gestation at the earliest.
The absence of an intrauterine gestational sac with such high levels of serum beta-hCG means that there is an ectopic pregnancy or recent complete miscarriage. An empty uterus with a positive urinary pregnancy test may also be due to very early pregnancy and needs a repeat ultrasound scan.
Importance of early confirmation
The confirmation of an intrauterine pregnancy at an early stage is necessary as it would avoid any confusion, unnecessary investigations, and interventions in early pregnancy problems. With the arrival of expectant and medical treatment and conservative laparoscopic management of ectopic pregnancy, an early diagnosis has become more important.
It reduces the patient’s anxiety associated with uncertainty about the diagnosis, investigations, and interventions. It also helps save resources and the cost in the long run.
The primary vascular-change
During early embryological development, trophoblastic lacunae develop from the spiral arteries on day nine or the 23rd day of gestation as vacuoles open within the syncytiotrophoblasts. The uteroplacental circulation is established by the 21st day or five weeks of gestation, and the heart begins to beat on 22nd day or five weeks and 1-day gestation.
Crown-rump length
Growth is approximately 1.2 mm per day, which may also be delayed in a normally developing pregnancy. Interval growth of Crown-rump length alone should not be used as a determinant of pregnancy loss.
Cardiac activity
The embryonic cardiac activity should always be visualized with a crown-rump length of more than or equal to 7mm. A slow embryonic heart rate of less than 80 bpm may suggest a guarded prognosis for the pregnancy. One must suggest a follow-up scan if clinically appropriate.
The earliest site of a pregnancy can be confirmed by the modalities available in clinical practice is 4-5 weeks. After considering the wide variability in actual efficiency in practice, the diagnosis is often delayed causing a lot of concern for the women and the gynecologists involved in her management.
This also increases the cost of treatment through the prolonged hospital stay, repeated hospital attendances and investigations, and sometimes unnecessary interventions.
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