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  1. #1
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    Default Twins question

    Hi, I'm sure this question has been asked before, but I'm wondering how common it is that a twin can be missed on early ultrasound? I had an U/S done at 5+6 (dates confirmed also). Bub was quite difficult to see, managed to get heartbeat vaginally. This is 5th pregnancy, I have one 2.5yr boy, this year have lost 3 babies with a 5wk chemical loss the month prior to falling pregnant with this baby. Now 7+1.
    I've been much sicker (all day) than the other 4, this is the first pregnancy my boobs have been sore all day every day-never had this before. My iron levels have been fine, yet I've had lots of dizzy spells and short of breath in this pregnancy (never had that in the others). My hpt showed positive at 6dpo, very clear at 7dpo.
    My hcg levels at 11dpo was 134 (PROG 76), 18dpo was 1950, & 25dpo is 26,900. Doubling time has remained at 43hrs even though I've read that after 6000 is reached doubling time should slow to around 72hrs or more...it's still at 43hrs! My levels are over 3 times higher than my levels with my last monitored baby at that point.
    My ultrasound at 5+6 showed my sac to be the size of 7+3, yet baby measured bang on dates I'd ovulated-so baby gestational age is correct! My grandmother is a fraternal twin. I've just had a strong feeling I'm having twins this time? I will be ecstatic with one healthy Bub or 2, but just wanting to know if anyone has Had an ultrasound not show a second baby early on??
    Last edited by Toffeeapple; 26-12-2015 at 13:40.

  2. #2
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    I'm confused by your description: you said when you had the TV-ultrasound, baby measured 7+3, which you said was congruent with your dates. How, then, did you arrive at the figure of 5+6? Just remembering that the earlier the scan, the more accurately it measures gestation.

    I'm also a bit dubious about a positive-HPT at 6dpo. I am not saying it can't happen, but it is extremely rare. Implantation usually occurs at 4-7dpo, and once implanted, it takes a few more days for bhCG synthesis, which is then detected in the blood and urine. This makes me question the way in which you determined you date of ovulation?

    To answer your question, at 7+3, if there is a twin-pregnancy, a TV-ultrasound should show 2 gestational sacs/2 foetal poles, 2 heart-beats, etc, depending on the type of twins.

    The next point is a bit controversial, but many ultrasonographer "purists" (and I'm a doctor, not an ultrasonographer) maintain that the earliest a heartbeat can be seen by TV-ultrasound is 6+2.

    Just remember that bhCG values vary enormously between person-to-person, and pregnancies in the same woman.

    Hope this helps make things a bit clearer?

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    She said sac measured 7+3 but baby measured 5+6

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    Quote Originally Posted by Lil Smurfy View Post
    She said sac measured 7+3 but baby measured 5+6
    OK, understood, but this complicates things a bit further. You're right Smurfy, the CRL (crown-rump-length) of the foetal pole is more accurate a prediction of gestation than the size of the gestational sac...but, all the literature I've looked at says the CRL does not become measurable until the 6 week mark has passed, but much more commonly not until 7+1.

    Any chance OP you know the CRL from your scan?


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    Last edited by J37; 26-12-2015 at 15:28.

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    All sounds strange. I don't even know why they'd bother telling her how the gestational sac measured.

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    At the end of the day, if you really did have a positive-HPT at the "true" 6dpo mark (and to establish this, exact ovulation date would have to be confirmed by ultrasound for example), AND you had a measurable CRL at 5+6, (remembering both are very rare likelihoods, but yes related), then the answer to your question is yes...in very early scans, twins can be very occasionally missed on ultrasound.

    There...we got there in the end

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    Last edited by J37; 26-12-2015 at 15:42.

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    How did you originally determine your ovulation day?

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    Default Twins question

    Hi toffeeapple! This can happen, particularly with a 'vanishing' twin (one twin does not progress). I had a vanishing twin with DS2 that did not show up until a 7 week scan. Even then it was mistaken for a clot but confirmed as a non viable twin at 12 weeks. It had disappeared completely by 19 weeks.

    Also, your hcg levels are about the same as mine for my current pregnancy (43000 at 5+6). Single pregnancy. I was pretty anxious about it because for some absurd reason they were worried about a molar rather than a twin. Was neither, just one baby causing a lot of angst. Hcg is a pretty bad indicator generally IMHO!
    Last edited by Sally1981; 26-12-2015 at 16:23.

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    Thankyou for the replies. The CRL was 0.40cm - gestational age 5+6. I am unsure why he told me the gestational sac measures larger at 7+3. I was using ovulation tests to indicate my date of ovulation, which correlates with the 5+6 age shown at my scan. (I also had an ultrasound that week for other reasons and the tech said I was due to ovulate from my right ovary that weekend- that was on a Tuesday, therefore another reason I'm sure I ovulated on that Friday.)
    I am aware of the massive ranges in hcg, I've been on beta base.com and have entered my levels - (all of which place me in triplet median range for hcg levels and doubling times.. )And I only entered these due to knowing that my levels were over triple those of my last monitored baby. I have another ultrasound in 3 weeks, I will know for sure, I'm happy either way, just impatient and wanted to ask if others had experienced a hidden twin early on. Thankyou for your replies.
    Last edited by Toffeeapple; 26-12-2015 at 18:56.


 

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