Fetal Heartbeat at 14 weeks

January 25, 2006 3:15 PM

MaternityFilter - Fetal Heartbeat Question.

I'm about 14 - 15 weeks pregnant. I had a normal ultrasound at 9 weeks, showed good fetal development, good heartbeat, etc. At my midwife appointment today she was unable to find a fetal heartbeat with the handheld dopler equipment in the office, and she suggested that they schedule me for another ultrasound image "in a week or so".

She did tell me several times not to worry, but I can't tell if she's genuinely not worried or is just masking her concern. She did say that she was using "the little" handheld unit, as her partner had take "the big" handheld unit to their other office.

How normal is it to be unable to hear the heartbeat at 14 weeks? I'm actually not completely paniced (just mildly worried) but my boyfriend is much more concerned. Should I push for a second ultrasound within the next couple days?

Nothing else seems to be "wrong" except my nasuea is easing up, which I'm told should be normal at this point.

Give me some data to help calm my sweetie down, please!

posted by anastasiav to health & fitness (19 comments total)

Well, I don't have any hard data to offer you, but my darling and I recently had a child (pics here) and I don't remember for sure what the heartbeat sounded like at 14 weeks. However, I do know that they had trouble finding it sometimes (we had to have her roll over and such).

My guess on the matter is that things are ok. If you or your adorable child is in trouble, the midwife would A: Be required to tell you, and more to the point B: The midwife would be DOING something about it. Again, I'd say don't worry. If the doctor doesn't think it's a danger, I'd take their opinion on the matter.

Hope this helps! And remember, MAKE PEOPLE GET BABY CLOTHES BIGGER THEN JUST NEW BORN AT THE SHOWER!!! :D
posted by TrueVox at 3:27 PM on January 25, 2006

I hope this post isnt too hard to read, but I somewhat recently went through this.

My wife and I are expecting our first. Had the first ultrasound around 9 or 10 weeks, and then we went in at about 12 weeks and the Doctor could hear the heartbeat fine on a handheld device. She is at about 20 weeks now and going along well.

My Brother and his wife announced that she was pregnant at about 9 weeks, we are buying a house about a mile away from them so our wives were extremely happy that the babies would be born within a few months of each other. At 9 weeks they had an ultrasound and everything looked healthy, and then they went in again for the 12 week and the baby had died. It was heartbreaking when my brother called me. This only happened a few days ago, so Im still having a hard time talking to them as he and his wife arent taking phone calls.

I hope that your baby is ok, but after recent events in my own family, if were you I would try and get an ultrasound quicker if only for your own peace of mind. Frazzled nerves are the last thing you need right now, the handheld devices are definitely not as reliable as an ultrasound and can depend on the position of the baby as well as the skill of the person using it.

I wish you the best and hope all is well.
posted by skrike at 3:46 PM on January 25, 2006

Mrs. Putzface posting here. Recent sabbatical from my midwifery apprenticeship (professional midwife, not nurse midwife), but thought I'd chime in. My answer is if you can't stop the worrying, then ask to have the ultrasound sooner. If you can deal with the wait, then wait.

There are a lot of reasons why your midwife may not have been able to hear heart tones. Some dopplers are better than others, baby could be in a funny position making it difficult to find just the right spot, maybe you're a little off on your dates.

The truth is that even though you are feeling bigger, that little one is still really little. Too small to palpate accurately, and therefore not always easy to find with a doppler.

I don't blame you for feeling worried. As they say, "Worry is the work of pregnancy", but don't assume the worst, there are other explanations.
posted by putzface_dickman at 3:48 PM on January 25, 2006

Finding a heartbeat with a doppler can be tricky. If your midwife felt there was reason to be concerned, she'd have referred you for an ultrasound posthaste.

Things like this are why I cringe at the home heartbeat microphones they sell at Babies R Us--can you imagine how crazy you'd drive yourself if you couldn't find the heartbeat with one of those? And then it's like--you just needed to replace the batteries, settle down.

A little paranoia goes with the territory of being pregnant, both for you and your partner. You're totally within the realm of sane if you would be inclined to push for a quicker followup on this.
posted by padraigin at 3:49 PM on January 25, 2006

We just had our second ultrasound (18 weeks) and our first one was at 7 weeks. In between the doctor had one hell of a time finding the heartbeat. Eventually, she did, but it was a scary 10 minutes.

The 18 week ultrasound and the triple-screen for chromosonal defects we just received were absolutely, 100 percent, no problems at all. The baby is healthy and moving and busily growing!

Please don't get too worried at your current stage...the doc is trying to find one sound among all the other sounds of the mom's heartbeat, the intestinal gyrations, and the baby sucking its thumb. All is likely very fine.
posted by Kickstart70 at 4:00 PM on January 25, 2006

Handheld ultrasound systems are much less sensitive than the large cart-based systems, they're just not able to pick up a lot of things that you would be able to see/hear on a larger system. Something like a fetal heartbeat that is difficult to find under normal circumstances, trying to do it with a portable system would be very challenging, and I would think it's not that unusual to not find it using a handheld system.
posted by orangskye at 4:24 PM on January 25, 2006

I had this exact same thing. Turns out I have a pretty retroverted uterus and it was nearly impossible to pick up the heartbeat down that low. My doctor ordered an ultrasound for later that day and it was an absolutely excrutiating 5 hour wait. If I were you - I'd schedule an ultrasound as soon as you can just for peace of mind.
I had seen the heartbeat on ultrasound at 10 weeks - so there was really no reason to worry - but when you can't feel them moving around - hearing and seeing are the only confirmation you have. I'd get that confirmation.
Sounds like Kickstart70's baby and mine are on the same schedule - i had my fancy ultrasound on Monday and she (yay) is doing great.
posted by Wolfie at 4:28 PM on January 25, 2006

when mrs. stupidcomputernickname was pregnant with one of our children either #2 or #3, we had the same problem, and everything turned out just fine... the two week wait that they made us go through was not pleasant.

We asked to have the 2d test the next day, and the dr's office told us that giving the baby a chance to grow a little bit more would make the 2d test much easier to perform. We considered switching OBs, but in the end we just waited the two weeks.

I know that saying "dont worry" is like dropping a rock and saying "dont fall", but just remember that there are others who had the same problem, and came out fine.

Good luck!
posted by stupidcomputernickname at 4:34 PM on January 25, 2006

Just chiming in, after having a healthy baby girl two weeks ago...sometimes we could hear the heartbeat on the Doppler early on and sometimes not. When you are not very far along, it is not always easy to "chase them down" in there.

AND...the thing that is also important is to make you comfortable with the pregnancy. I don't think it would hurt to ask for the ultrasound early just for your peace of mind, as others have said. We had an ultrasound in Week 5 because I was having sharp abdominal pains (which turned out to be a cyst on my ovary). There was nothing on the Doppler that early, but on the ultrasound we saw "the Bean" and heard/saw her heartbeat. It surprised me because I didn't think I'd see much of anything at 5 weeks.

Congratulations and take care of yourself...
posted by jeanmari at 5:19 PM on January 25, 2006

As an obstetrician, I can tell you that what has happened is quite common at this stage. Nonetheless, I would insist on a repeat attempt at finding the heartbeat or an ultrasound just to allay your concern.

The fetal heart beat is heard best through the baby's back (!) so the baby must have it's back facing up for the heartbeat to be detected easily. That's usually no problem later in pregnancy since the baby is so large and the doctor or midwife can identify the position of the baby by feeling your abdomen.

At 14 weeks, the baby is relatively small and can move quickly and freely throughout the uterus. That makes it difficult to catch the heartbeat at times.

If you are comfortable waiting (since the odds are high that everything is fine), there's no problem in waiting. If you are nervous, your midwife should do whatever is needed (listening again with the doppler, an ultrasound) to reassure you that the baby is fine.
posted by DrAmy at 5:24 PM on January 25, 2006

My sister had a similar thing happen around this stage when Nephew 2 was swimming around in utero, and I think the same may have happened with Nephew 3.

Oh, and congrats!!
posted by scody at 5:37 PM on January 25, 2006

My not quite six month old's heartbeat wasn't detected by doppler until I was 20 weeks. Being a very fluffy woman, i wasn't surprised, but had I been let to believe that this was a problem, I would've panicked. DrAmy nailed it, and try not to worry. It's probably just fine, and worrying never solved anything.
posted by Dreama at 6:12 PM on January 25, 2006

You don't say you are experiencing any bleeding. Bleeding is a big sign that a miscarriage has occurred. Also you're not in the first trimester anymore, which is when miscarriages are more likely to occur. So, that's 2 good signs.

Since you specifically say your boyfriend is stressing, here's something you might do: take another pregnancy test. According to this eMedicine article, and Wikipedia, if you have experienced a spontaneous abortion, aka miscarriage, then your pregnancy hormone levels will drop. So a negative pregnancy test at this point would be a clear sign that something is wrong. A positive test doesn't necessarily mean all is perfect, but you might feel better driving to CVS, buying the test, and actually doing something instead of just what-iffing.

And ditto all those who have said push for a faster ultrasound. Your peace of mind is worth it.
posted by selfmedicating at 6:13 PM on January 25, 2006

(Nice answer, Dr. Amy -- flagged as fantastic. And I just took a look at Ask Dr. Amy -- interesting! There are some issues with layout in Safari on the Mac, though... I'd have dropped you an email if your email was in your profile here.)
posted by delfuego at 7:01 PM on January 25, 2006

Regarding selfmedicating's comment: Even after an obvious spontaneous abortion, it takes quite a while for hcg levels to drop back to zero. A home pregnancy test, which triggers positive at very low levels, most likely won't give a definitive answer.

There's some great advice in this thread. I wish you the best, and peace of mind. (Speaking as somebody who's seen both sides of the coin.)
posted by moira at 7:48 PM on January 25, 2006

Hmm, in Japan we got ultrasound every appointment, which was every month, and every week in the last month.

You could always go again, and just pay for it yourself.

In the end we have a nice photo album of just ultrasounds :)
posted by lundman at 7:54 PM on January 25, 2006

Small update: although it took a bit of convincing and a few calls, I was sent for an ultrasound today. Fetal heartrate is 158 and everything looks "fine".

Thanks to everyone for your help and support.
posted by anastasiav at 12:07 PM on January 27, 2006

Very glad to hear that -- good luck with the rest of the pregnancy, and remember to play the "I'm eating for two" card every time anyone asks you how much ice cream you want!
posted by delfuego at 11:51 AM on January 28, 2006

Glad to hear the happy news, anastasia.
posted by scody at 12:01 PM on February 1, 2006