FHR = 54bpm
I went in Tuesday for my third trans-vaginal (i.e. “dildo-cam”) ultra-sound at 6w4d. Fetal Heart Rate = 74bpm. Ideally it should be between 120-160, but early on anything above 100 is good. 74 is not good.
I also had some bleeding in the sac, although it is impossible to know how long it had been there.
I knew it wasn’t good when my doctor called to tell me the news. Usually the nurse calls with the good news (“Your betas have more than doubled!”; “The ultrasound showed a gestational sac and egg sac that are exactly appropriate!”). When there is bad news, I guess the doctor calls. She was “concerned” and wanted me to come in for a follow-up u/s the next week to monitor the FHR (fetal heart rate). Doctor: full pelvic rest and progesterone suppositories. Me: hysteria and emotional meltdown.
Here’s what NOT to do in this situation: Google “low fetal heart rate.” Baaaaaaaaad idea. There are three types of information out there: anecdotal stores on pregnancy boards, websites filled with sourceless information, and medical journals that use obtuse language and are filled with statistics. I am an educated woman, trained to be critical of information. So, of course, I start with the scary medical journals. As my hysteria gradually builds with every ominous article, I find myself instead on the pregnancy boards reading wrenching stories from 2005 of other women who have gone through this same nightmare. I find them more comforting, even if the majority of them are in bad need of spell check. Here’s what everyone can agree on: low fetal heart rate (below 100) is not a good sign and the majority (68% I read somewhere that I am too drained to go back and reference) end in miscarriage.
I should mention that I have clinical depression and usually take 60mg of Prozac a day. While ttc I weaned off the Prozac completely and had a go at an SSRI-free existence. After that failed miserably, my doctor and I agreed to try 20mg a day instead. I found that I could function at this dose and the incessant crying and excessive lethargy had abated. Undermedicated, yes. Ideal, no. Workable, sure.
I should also mention that I had a “blighted ovum” (who comes up with these terms?) last October that was discovered at my 10-week ultrasound. But that is for another post ….
Lastly, I was also contending with severe nausea and vomiting — the “good” signs of any first-trimester pregnancy — so trying to process bad news in my ralphing, undermedicated, jaded-from-miscarriage #1 state was very difficult. My husband, who works in the same hospital as my OB’s office, went to ask if my doctor had any objections to me upping my Prozac dose to 40mg. The OB was out, but the nurse midwife, after being given the Reader’s Digest version of my medical history, thought that was an excellent idea. She also — bless her soul — moved the ultra-sound up to Friday, today, so perhaps I could find out something before the weekend.
Here is what I found out: FHR = 54bpm. Non-viable pregnancy.
The D&C is scheduled for Monday at 6:30AM, assuming that the little heart has stopped beating by then. (It is office policy not to do a D&C if there is still a heartbeat, I am sure for legal liability). If not, they reschedule the procedure for next Wednesday and I have another ultrasound. I am not naive: I know the heartbeat is not going to miraculously shoot back up into the normal range. It is slowing down and the embryonic heart is dying. I just feel like a horrible, horrible person for even thinking “I hope the little heart stops beating soon.” I don’t want it to every stop, actually. I want it to keep beating and grow as it should into a healthy baby. That, however, is not going to happen. So I guess, yeah, I do want it to stop beating by Monday, but I still feel for awful thinking and writing that.